One-Stage Suprapubic Prostatectomy

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THE value of suprapubic prostatectomy has been established by many years of experience with the operation. Not infrequently, however, accepted procedures are improved and such advances may go unheralded or taken for granted. With the introduction of other surgical procedures for the correction of benign prostatic hypertrophy it seems timely to review suprapubic prostatectomy to see if it has maintained its place in the surgical treatment of this condition.

One-stage suprapubic prostatectomy in itself represents an advance. Many can recall the days of the two-stage operation, and one leader in urology even advocated a three-stage operation at one time. The multiple stage operations doubtless served a useful purpose but they are no longer necessary. With the one-stage operation one avoids long periods of hospitalization and there is less morbidity and fewer complications.

Several factors may be mentioned as having accelerated the adoption of a one-stage prostatectomy. In the past decade or two the increased safety of prostatic surgery has encouraged patients to seek relief earlier. Thus, patients in a younger age group come to us in better general health and before extensive renal damage is present. The introduction and intelligent use of the sulfonamides and antibiotics is another important factor. Before their introduction, urinary sepsis was a major cause of catastrophe in prostatic surgery and there was no satisfactory treatment.

Although it appears paradoxical on first consideration, I believe that transurethral resection increased the safety of one-stage prostatectomy. This was accomplished by providing us with an operation to relieve the. . .



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