Prostatic obstruction is relieved in one of two ways: through the cysto-urethroscope or through a suprapubic or perineal incision. It is of vital importance to the patient that the bladder neck obstruction be removed —if not, the resultant renal insufficiency will probably remove the patient.
Prostatectomy is too well known to most surgeons for me to comment on any particular feature of the operation. However, it is my present belief that a patient suffering from benign enlargement will be better off with a prostatectomy than with transurethral surgery, in the hands of many urologic surgeons (especially those who perform only the odd transurethral operation).
Prostatic bars, obstructing prostatic carcinoma and scars, slight and moderate intra-urethral lateral and median lobes are ideally suited for urethroscopic excision by the trained transurethral surgeon. The markedly enlarged prostate, bulging into the rectum and urethra, had best be removed by prostatectomy.1
A report of
COLLINGS CW. THE RELIEF OF PROSTATIC OBSTRUCTION. JAMA. 1934;102(2):123-126. doi:10.1001/jama.1934.02750020035008