Transurethral prostatectomy

In properly selected patients, TURP has the highest probability of symptom relief of any strategy of BPH management except open prostatectomy, the outcomes of which are but marginally better. However, open prostatectomy suffers from lack of patient acceptance, increased postoperative discomfort, and prolonged hospitalization, factors which over the past six decades relegated it to a minor role in the surgical management of BPH. Given the advanced age and compromised health status of most men undergoing TURP, the procedure's current mortality, morbidity, and long-term complication rates are remarkable. The ultimate role of the emerging alternative strategies of BPH management-hormonal, pharmacologic, thermal, and device discussed elsewhere in this issue, will be dependent upon their durability and their long-term outcomes, which remain to be fully defined. In the meantime, TURP remains the standard against which all new therapies must be measured. The resectoscope is being challenged but is not yet ready for the history books.