Sisir Kumar Saha1. 1. West Wales Hospital and Other Hospitals, Carmarthen, UK.
Abstract
UNLABELLED: Although transurethral resection of the benign prostate (TURP) is a popular technique, it is not without problems. The average postoperative morbidity could be up to 50%. Therefore the quality of life and the total cost have been evaluated in this study, since the incidence of re-TURP was reported to be as high as 25% in 8 years period. This was attributable to incomplete resection, in that only about 40% of the prostatic tissue being resected by this technique. In contrast, transcervical prostatectomy (TCP) performs a total enucleation of the gland. It seems to be cost effective, in that the postoperative urethral catheter is removed routinely on the second day and the patients are discharged home on the fourth day routinely. The total incidence of morbidity, by contrast, was less than 5% and that of mortality under 1%. The initial cost for the primary operation would not be much difference between the these two techniques, but the average cumulative cost per TURP would be expensive, if all the expenses incurred for the treatment of postoperative complications are added together. It would be between pounds sterling 2574.00 and pounds sterling 2434.00, for the primary operation. But the cumulative cost for TURP would be pounds sterling 4333.00 and for TCP pounds sterling 2580.00. The true cost for the operation of TURP could be as high as pounds sterling 10720, compared to pounds sterling 2434.00, being the operation charge for TCP, if all expenses have to be paid by the patient. CONCLUSION: Transcervical Prostatectomy compares favourably with TURP in every aspect, apart from the skin cut in the lower abdomen.
UNLABELLED: Although transurethral resection of the benign prostate (TURP) is a popular technique, it is not without problems. The average postoperative morbidity could be up to 50%. Therefore the quality of life and the total cost have been evaluated in this study, since the incidence of re-TURP was reported to be as high as 25% in 8 years period. This was attributable to incomplete resection, in that only about 40% of the prostatic tissue being resected by this technique. In contrast, transcervical prostatectomy (TCP) performs a total enucleation of the gland. It seems to be cost effective, in that the postoperative urethral catheter is removed routinely on the second day and the patients are discharged home on the fourth day routinely. The total incidence of morbidity, by contrast, was less than 5% and that of mortality under 1%. The initial cost for the primary operation would not be much difference between the these two techniques, but the average cumulative cost per TURP would be expensive, if all the expenses incurred for the treatment of postoperative complications are added together. It would be between pounds sterling 2574.00 and pounds sterling 2434.00, for the primary operation. But the cumulative cost for TURP would be pounds sterling 4333.00 and for TCP pounds sterling 2580.00. The true cost for the operation of TURP could be as high as pounds sterling 10720, compared to pounds sterling 2434.00, being the operation charge for TCP, if all expenses have to be paid by the patient. CONCLUSION: Transcervical Prostatectomy compares favourably with TURP in every aspect, apart from the skin cut in the lower abdomen.
Authors: N P Roos; J E Wennberg; D J Malenka; E S Fisher; K McPherson; T F Andersen; M M Cohen; E Ramsey Journal: N Engl J Med Date: 1989-04-27 Impact factor: 91.245