LAUSR

INTRODUCTION Benign prostatic hyperplasia (BPH) is one of the most common problem in the elderly men. TURP can be performed for most patients who need re-do prostate surgery, but open prostatectomy should be considered in patients with prostate size larger than 70 grams. This study assessed the feasibility of open prostatectomy (OP) after previous TURP in patients whose prostate size is larger than 70 grams. PATIENTS AND METHODS We subdivided patients into two groups: the group one included patients who had a history of prostate surgery presented with severe voiding symptoms and a large prostate (>70 gram). Patients who are candidate for open simple prostatectomy without a history of prostate surgery are included as group 2. RESULTS Between June 2007 and April 2018, 2700 patients underwent TURP or open prostatectomy in our department. 152 of 2700 patients came to us because of severe voiding symptoms after previous prostate surgery, but only 30 patients met the criteria to be enrolled in this study. Perioperative complication (capsular perforation) was happened in 4 patients (13.3%) in group one whereas none of the patients in the group 2 had capsular perforation. Hemoglobin drop in the patients of the group one was not significantly different from patients of group 2. The rate of blood transfusion is not different between groups (2 patients (6.6%) in group one and 41 patients (5.6%) in group two). After 6 to 12-months, re-operation rate due to urethral /bladder neck stricture was done in 10 patients (30%) of the group one and 15 patients (2%) of the group 2 (p <0.05). Four patients (13.3%) of the group one complained of urinary leakage more than one pad per day 6 months after the operation whereas 5 patients of the group 2 had urinary leak more than one pad per day (0.7%) (p >0.05). Hospital stay was slightly longer in patients in group one. Patients' quality of life was better in the group two compared with group one 6 months after the operation (p <0.05). CONCLUSION Open simple prostatectomy is a feasible procedure in patients with large prostate after previous TURP, but it is associated with more complications in the long term.