[Evidence on the improvement of quality standards for retropubic surgery for BPH]. / Evidencias de la mejoría de los standares de calidad en la cirugía retropúbica por H.B.P.

OBJECTIVES: To report the first consolidated results of the technical variation of the bladder-capsule plasty, a complement of the well-known trans-cervical hemostatic adenomectomy. METHODS: We analyze 65 recent consecutive patients with BPH undergoing surgery by such technique with follow-up between 6-48 months, analyzing the parameters which in this type of operation are significant to evaluate quality. RESULTS: We evaluated bleeding, transfusions, surgical wound complications, postoperative discomfort, number of days with catheter, and hospital stay; also reoperations and morbidity-mortality, which show a notable improvement in comparison with what appears to be typical of this operation, considered the most aggressive approach for the surgical treatment of BPH. CONCLUSIONS: We report a personal modification of the transcervical hemostatic adenomectomy, published in 1974, after an experience of more than 1000 operations: the bladder-capsule plasty. The changes introduced in this 65 cases make us consider, even in present times, open surgery for BPH as the best solution for the obstructive problem in selected cases, with the lowest reoperation rates, and improving on factors such as "invasiveness" and "higher cost" which have been historically attributed to it.