A Population-Based Study of Prostatectomy: Outcomes Associated with Differing Surgical Approaches

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Abstract
Data from the universal health insurance system in Manitoba, Canada were used to describe the short-term (2 years) and long-term (8 years) outcomes associated with prostatectomy for nonmalignant conditions (all 2,699 procedures were performed from 1974 to 1976). In a system with high quality urological care (more than 90 percent of the procedures were performed by urologists) no superior operative results for transurethral procedures were found. Postoperative mortality rates following transurethral prostatectomy were similar to or higher than rates for open procedures, and the rate of repeat prostatectomy, was considerably higher following transurethral resection. Dilation for urethral stricture was most common after suprapubic prostatectomy and least common after retropubic prostatectomy. Patients were followed for 8 years and those who underwent transurethral prostatectomy required an additional prostatic operation at a constant rate (2 percent per year). By the end of the followup period 16.8 percent of the transurethral prostatectomy patients had undergone a second prostatectomy compared to 7 percent or less of those who initially underwent an open procedure.