"Prostatectomy"--an optional no-catheter technique

Suprapubic prostatectomy combined with vesico-urethroplasty

A new look at the operation of suprapublic prostatectomy is suggested in view of the continuing substantial morbidity associated with traditional techniques. The proposition is that a reconstructive as distinct from a simple ablative operation is possible, notwithstanding long-standing beliefs to the contrary. The writer goes on to outline the principles, and to describe and illustrate in detail the steps in a new technique of prostatectomy combined with a urethroplasty, which uses full-thickness bladder wall flaps to provide immediate epithelial cover for the denuded surfaces of the prostatic urethra. The theoretical advantages of such a technique are borne out by the results in the first 400 cases so treated, which are contrasted with those from a comparable personal series of 200 retropubic prostatectomies and other representative series.

Early removal of catheter after transurethral prostatectomy

A prospective study of 100 patients with benign prostatic hypertrophy treated by transurethral prostatectomy with catheter removal as soon as possible after surgery was carried out. The results were compared with a retrospective review of 100 similar cases treated by long-term catheter drainage. Incidence of retention requiring recatheterization was equal (5 per cent versus 6 per cent); incidence of secondary hemorrhage was increased by early catheter removal (6 per cent versus 13 per cent); postoperative hospital stay was decreased by 50 per cent (8.2 versus 4.0 days); and patient comfort and acceptance were improved markedly.