Transurethral prostatic resection with suprapubic trocar technique.

The use of a suprapubic trocar in transurethral prostatic resection was evaluated between 1975 and 1982. Of 884 transurethral prostatic resections performed 577 were done using the trocar, and 307 using the conventional filling and emptying technique. There was no difference in operative time when resecting small glands. All large glands (more than 30 gm.) were resected using the trocar technique. Severe cases of the so-called transurethral resection syndrome have been eliminated completely by this procedure. The blood loss was slightly higher when the trocar technique was used, probably because of the low pressure in the prostatic fossa during resection. We recommend the trocar in transurethral prostatic resection, since it facilitates the procedure by allowing uninterrupted resection, keeps the bladder pressure low and, thereby, minimizing the amount of absorbed irrigating fluid, and has practically no complications.