[Trigono-cervico-prostatotomy (TCP) versus transurethral resection of the prostate (TURP). Our experience].

OBJECTIVE

Trigonocervicoprostatotomy (TCP) has been considered up to now an alternative treatment to transurethral resection of the prostate (TURP) when evaluating the size of the prostate. This paper demonstrates that endoscopic visualization is more important when choosing the surgical procedure and that both techniques can achieve satisfactory results.

METHODS

The prostate volume is evaluated by ultrasound and according to the endoscopic findings, TURP or TCP is performed. The prostatic lobes are routinely biopsied if the latter procedure is chosen.

RESULTS

We compared the results of 34 TCP and 30 TURP procedures using the values of I-PSS and uroflowmetry before and after surgery. In 86.2% of the TCPs and 80% of the TURPs, the patients are asymptomatic with I-PSS less than 7 and significantly improved uroflowmetry data. Biopsy disclosed adenocarcinoma in one patient submitted to TCP.

CONCLUSIONS

TCP represents an alternative to TURP not only for small prostates (30 gm) but also for medium-sized prostates (50-60 gms), depending on the endoscopic findings. TCP is not indicated for lateral lobes that fall on the prostate floor. Performing a biopsy routinely in TCP does not prolong the operating time significantly and permits detecting subclinical adenocarcinoma of the prostate.