Prostatectomy or Conservative Management in the Treatment of Benign Prostatic Hypertrophy?

A randomised, prospective trial comparing transurethral prostatectomy with conservative management was carried out in 38 men with proven bladder outflow obstruction. Patients were assessed urodynamically before treatment and 6 months later. All 21 patients who had a prostatectomy showed a significant improvement in peak flow rate, voiding pressures and residual urine volume, but only 71% were symptomatically better. Of the 17 patients treated conservatively, 56% noted an improvement in their symptoms, although their peak flow rates and residual urine volume were virtually unchanged. Following prostatectomy, the incidence of detrusor instability fell by 78%, whereas in the conservatively treated group the reduction was only 50%. Patients who had done well or badly after treatment were analysed as separate subgroups. The single…