Factors Affecting the Morbidity after Transurethral Prostatectomy for Benign Prostatic Hyperplasia

Jang, Jeong Hoon; Song, Jae Mann

Abstract

Medical records of 570 patients underwent transurethral prostatectomy from 1985 to 1991 were reviewed to analyze the factors affected morbidity after transurethral prostatectomy retrospectively. Transurethral prostatectomy constituted 16.9% of the urologic operation during above periods and there were benign disease in 513 patients(90%), and carcinoma in 57 patients(10%). Age of the patients ranged from 48 to 93 years old with a mean age of 68.3. Of the patients, 298 patients (52.3%) had significant pre-existing medical problems. The resected net tissue weight ranged from 3 to 73 grams, with a mean of 11.8 grams. The mean operation time was 53 minutes with a range from 25 minutes to 126 minutes. The mortality was 0.36% and the operative morbidity was 20.3%. Increased morbidity was found in patients with a resection time of more than 90 minutes, used glycine of more than 20,000ml and resected weight of more than 31 grams (P<0.05) But age greater than 80 years, azotemia, urinary tract infection, serum Na+ change and pre-existing disease did not increased the operative morbidity. Voiding symptom was improved in 551 patients(96.7%) but in 19 patients(3.3%). persistent voiding difficulty was found. postoperatively at three months The causes of voiding difficulty were as follows ; 10 incontinence patients, 8 detrusor areflexia patients and 1 urethral stricture patient. In conclusion, transurethral prostatectomy is one of the most common operations today with a very low mortality and the overall postoperative results are excellent. Further studies, such as a randomized trial, will be necessary to evaluate the long-term outcome of transurethral prostatectomy further.