A Clinical Observation on Transurethral Resection of the Prostate with Suprapubic Cystostomy

Han, Ki Young

Abstract

A clinical observation was made on 143 cases who received transurethral prostatic resection in the Department of Urology. Korea University College of Medicine during the period of 4 years and 8 months from Jan. 1970 to Aug. 1975. Previous to the transurethral resection of prostate, the suprapubic cystostomy was accomplished in 79 cases among them and following advantageous results were obtained. 1. For the fast recovery of uremic condition and bladder tonicity for over distended bladder, the suprapubic cystostomy is inevitable. 2. It minimizes bleeding of the prostate during transurethral prostatic resection as the drainage of suprapubic cystostomy induces to subside the congestion, inflammation and swelling of the prostatic glands. 3. It tends to minimize and prevent absorptive complications. Complications from absorption of large quantities of irrigating fluids into the circulatory system include hyponatremic shock, water over loading of the vascular system or hypervolemia and hemolysis. By lessening intravesicular pressure and operative time, it thereby reduces the amount of irrigating fluid absorbed. 4. It provides clear view of surgical landmarks with greater margin of safety since water flow is always maximal. S. By eliminating the time spent for evacuation of the bladder, eye accommodation and re-establishment of surgical landmarks, it permits transurethral resection of larger glands within recognized safety guidelines. 6. It reduces operative time. This decreases operative risk, since complication rates, especially in elderly patients, rise in direct proportion to the length of the surgical procedure. 7. It provides a new light source such as fiberoptic cystoscope through the opening of suprapubic cystostomy 8. Make it possible to observer the technique of operation by the lens system inserted through the suprapubic opening.