Benign Prostatic Hyperplasia: 5-Year Experience / 대한비뇨기과학회지

ABSTRACT

Three hundred and ninety patients with benign prostatic hyperplasia managed at Seoul National University Hospital during a 5 year period from 1981 to 1985 were analyzed retrospectively. Most patients experienced urinary retention(60.3%) or had significant residual urine(l2.O %). Azotemia was found in 41 patients(10.5%) and bacteriuria in 67 patients(l7.2%). Intravenous pyelography was performed routinely in most of patients but it did not contribute significantly for the management. 217 transurethral(55.6%), 124 suprapubic(31.8%), and retropubic resections(12.6%) were done according to size of prostate, patient`s general condition and surgeon`s preference by 27 operators including 20 senior residents. The mean weight of resected tissue was 14.5gm in TUR and 36.1gm in open resection. The mean perioperative transfusion was l.2 pints in TUR and 2.2 pints in open resection. Overall morbidity of prostatectomy was l7.4% and there was no difference between TUR and open resection. Excessive bleeding was the major complication which developed in 6.9% of TUR and 6.4% of open resection. Initial azotemia, bacteriuria and old age over 80 years did not increase the operative morbidity. In TUR, 30gm or more of resceted adenoma and/or 90min or more of resection time increased the morbidity significantly. Prophylactic antibiotics decreased the postoperative urinary tract infection. The antibiotics were continued until 5~7 days after removal of catheter, and an additional antibiotics were not necessary even in the presence of microscopic pyuria which persistence for longer time. In 351 patients(90.9%), voiding problem was improved but in 39 patients(10%), it was persisted. Uroflowmetry was useful to evaluated the outcome of the resection. Maximum improvement in the flowrate was found 3 month postoperatively and the result was same in the patients with TUR and open resection.