TRANSURETHRAL RESECTION OF THE PROSTATE: STILL THE GOLD STANDARD

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Abstract
Background: In recent times there has been a number of newer methods advocated as treatment for bladder outlet obstruction. Prior to embracing these newer technologies, the authors' experiences with conventional transurethral resection of the prostate should be evaluated and compared with those experienced in the newer modalities. The objective was to determine whether a standard transurethral resection of the prostate (TURP) still compared favourably with the newer modalities in terms of duration of stay, duration of catheterization, re‐admission rate, re‐catheterization rate, cost and long‐term results. The results are compared with those of workers whose level of expertise was the best that could be achieved with transurethral needle ablation (TUNA) and laser prostatectomy. Methods: During the 3‐year period from September 1992 to September 1995, 575 TURP were carried out in a regional hospital. The total duration of stay, the postoperative duration of stay, the re‐catheterization and re‐admission rates were assessed and the costs estimated. Results: Transurethral resection of the prostate was shown to compare favourably in terms of the duration of hospital admission and the duration of catheterization, and to have a significantly lower re‐catheterization rate and a significantly lower re‐admission rate than the newer modalities. Conclusion: Transurethral resection of the prostate is still the method of choice for surgical management of bladder outlet obstruction, and it remains as the gold standard. Having reviewed the results of the newer modalities as carried out by the experts in those fields, it was found that TURP compares favourably with those procedures. From the point of view of duration of stay, duration of catherization, re‐admission rate and re‐catheterization rate, as well as cost and long‐term results, TURP remains as the gold standard and the newer modalities are not believed to be advantageous at this stage.