Urologie pro praxi 3/2002
Prostatektomie: minulost, současnost, budoucnost…
Prostatectomy – past, present and future Prostatectomy is one of the most frequent urological procedures performed in the developed world. The original open surgical approach has now been replaced by transurethral techniques. Of these the transurethral resection of the prostate (TURP) is the most common and is now being considered for the gold standard for therapy of BHP. Procedures on the prostate have undergone a relatively long evolutionary process, from the practice of healers to the first open surgical methods performed and based on the knowledge of anatomy and physiology at the time to the modern trend of the less invasive techniques. Indications for the removal of the prostate are, according to the „International Consultation on BHP“, recurrent retention of urine due to BHP, recurrent urinary tract infections due to BHP, recurrent macroscopic haematuria due to BHP, renal insufficiency caused by BHP, cystolithiasis caused by BHP and diverticulum of the urinary bladder due to BHP. The peri- and post-operative morbidity and mortality of these particular types of procedures are assessed, the occurrence of such complications as erectile dysfunction or incontinence are compared and their impact on urinary flow value (Q max) is evaluated. Techniques for both open and endoscopic procedures on the prostate are introduced. The near future will reveal which method will be adopted as the new gold standard for the therapy of BHP. Key words: benign hyperplasia of prostate, prostatectomy, TURP.
