Transurethral incision versus resection of the prostate for small to medium benign prostatic hyperplasia

Objective  To compare the effects of transurethral incision and resection of the prostate in patients with small to medium benign prostatic hyperplasia. Patients and methods  Patients were assessed pre-operatively using the Madsen-Iversen symptom score, post- void residual urine volume, urinary flow and cystoscopy. Those eligible for the study were randomized to undergo either transurethral incision or resection of the prostate. Follow-up visits were scheduled at 2–3, 6, 12, 24 and 60 months post-operatively with an assessment by symptom score and urinary flow rate; most patients also underwent cystoscopy at 24 and 60 months. Results  The maximum urinary flow rate was significantly higher in those undergoing resection than incision at all but the last follow-up visits. Cystoscopy 24 months after surgery showed adhesions between the lateral lobes, closed incisions or obstructing prostatic lobes in most of the patients undergoing incision, but not in those resected (P<0.001, chi-square test). During follow-up, a second transurethral procedure was carried out for persistent or recurrent symptoms, combined with a maximum urinary flow rate of <10.0 mL/s, in 10 patients who underwent incision and in three who were resected (P=0.039, chi-square test). Conclusion  Transurethral resection is preferable to transurethral incision of the prostate in the treatment of small to medium benign prostatic hyperplasia.