Roshan Ali Solangi, Jan Muhammad Memon, Nazar Ali Memon, Abdul Razaque Qazi.
Clinical evaluation of transvesical versus transurethral prostatectomy.
Med Channel Jan ;13(2):17-20.

OBJECTIVES: To compare the clinical results of morbidity and mortality of transvesical (TVP) and transurethral prostatectomy (TURP) in the management of benign prostatic hyperplasia (BPH). DESIGN: A department based prospective and randomized clinical audit. SETTING: Department of surgery and urology of NawabShah Medical College Hospital Nawabshah Pakistan over a period of 18 months from September 2003 to February 2005. SUBJECTS: A total of 100 patients with lower urinary tract obstruction secondary to BPH, under going transvesical, transurethral prostatectomy (50 patients in each group) were evaluated for clinical pattern of disease and postoperative complications during 06 (six) months follow up period. OUTCOME MEASURES: Age, clinical pattern, accompanying diseases early postoperative complications, hospital stay and mortality. RESULTS: In this study patients were belonging to mean age group of 16.12 and 63.37 years in TVP & TURP group respectively. They presented with variable symptoms of LUTS as prostatism, retention of urine, haematuria, haematuria with prostatism, retention of urine usually. In addition to that 61 patients were having associated surgical problems such as vesical calculus, renal stones, bladder diverticuli, inguinal hernia, haemorrhoids, gall stones and stricture urethra or medical problems such as hypertension cirrhosis, ascites, diabetes mellitus, chronic obstructive pulmonary diseases, asthma, anemia and CVA. 56 patients i.e. 31 belonging to TVP & 25 to TURP group developed postoperative complications like haemorrhage, clot retention, urinary incontinence, epididymorchitis, wound infection, osteitis pubis and urinary leakage. The mean hospital stay in TURP group was 13.4 and in TVP group 13.78 days. CONCLUSION: Prostatectomy is one of the most common operations now days. Suprapubic prostatectomy is well-controlled, safe and effective with low morbidity rates. TURP is considered the "gold standard" through out the world and only minor and insignificant differences are observed in this study.

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