BHP TREATMENT. OPEN PROSTATECTOMY: RESULTS
It’s important to understand that no form of prostatectomy stops BPH; these procedures only treat the disease that’s present. It’s a bit like mowing the lawn, in that, depending on how fast the prostate grows back, the procedure may have to be performed again.
In a recent study of more than 400 men who had the TUR procedure, symptoms improved markedly in 93 percent of those with severe manifestations of BPH, and in 79 percent of those with moderate problems. None of the men died as a result of the procedure, none had a heart attack, and only 5 percent reported impotence. In other research on men who’ve undergone the TUR, the improvement in urinary flow has been shown to last longer than seven years after surgery in most men.
Despite generally excellent results, TURhas come under fire recently. Some research has suggested that it’s less effective, in the long run, in fighting urinary obstruction than open prostatectomy. One such study examined the long-term progress of men in Denmark, England, and Canada, who underwent either open prostatectomy or TUR: 13 percent of those who had TUR needed a second procedure, as opposed to 3.5 percent of men who’d had open prostatectomy. (The proportion of men having had a TUR who need a repeat TUR amounts to about 1 percent to 2 percent a year.) However, from this and other studies, it’s clear that, given the choice, many men would rather have two TURs over ten years than one open prostatectomy.
In the same controversial study, investigators raised another issue: The statistics suggested that, four or five years after surgery, TUR might be associated with a higher likelihood of death from heart attacks than open prostatectomy. (The likelihood of a man dying from a TUR itself is almost nonexistent—less than 0.5 percent.) Further research, however, brought an explanation—that men undergoing open prostatectomy were healthier to start with. Men with heart disease and a large prostate were excluded from undergoing open prostatectomies; the more complicated nature of this procedure demanded healthier patients. With the simpler TUR procedure, however, nearly all men—including those with heart disease—were still considered eligible for surgery. Thus, the increased number of deaths from heart disease four or five years after surgery can be fully explained by the fact that more men with heart disease underwent a TUR than underwent open prostatectomy.
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Tags: Erectile Dysfunction, Men’s Health