A comparison of suprapubic transvesical and reserving the prostatic urethra prostatectomy for the treatment of benign prostatic hyperplasia

Objective: To review and compare the outcome of patients with benign prostatic hyperplasia （BPH） undergoing suprapubic transvesical prostatectomy or Madigan prostatectomy.Methods: Suprapubic transvesical prostatectomy was performed in 150 patients of BPH and Madigan prostatectomy carried out for 160 patients. The following variables were assessed: operation time, estimated blood loss （EBL） and serum hemoglobin, length of stay, short-term complication rates. Results: There were no significant differences in either the preoperative and postoperative IPSS or urodynamic parameters in both groups. The chief advantages of the Madigan prostatectomy were less trauma to the urethra, which resulted in significantly little blood loss（184.2 ±34.5ml versus 356.6±38.4ml）, shorter catheterzation duration（5.6±2.7d versus 12.2±5.1d）and length of stay（20±0.5d versus 29±0.7d）, few complications, rapid recovery and preservation of antegrade ejaculation. All these differences were statistically significant compared with suprapubic transvesical methods（P＜0.05）. Conclusion: The Madigan prostatectomy is believed to be the effective and ideal open prostatectomy, and provided good surgical results in our experience.