[20 years of prostate surgery. Reduction in the number of complications through application of a new concept in TUR, cryosurgery and surgical procedures].

During the last 20 years a deep change took place in the technique as well as in the conception of the operations of the prostate gland in adenomas and carcinomas. The endoscopic methods were adapted to the physiology of the urinary tract and to the condition of the patient; thus the general complication and lethality rate was decisively lowered (reduction of the general postoperative lethality from 1.2% to 0.77%). -- The operation method is selected according to the degree of risk of the patient. The TURP with the new low pressure technique (72%) and the freezing (25%) also in the adenoma of supersize are preferred. On the other hand, the surgical interventions rich in loss (lethality 3.3-4.3%) are decisively reduced (below 3%). -- The new endoscopic technique of cryosurgery guarantees a high value operation also for patients with a high risk (lethality 1.8%), in which cases the failure rate of the other method is indirectly decisively reduced (TURP 0.3%, radical TUR 0.7%). The carcinoma is (sub-) radically resected, and resected with increased risk or relapse, respectively; lymphadenectomy and radiation therapy supplement these operations.