Prostatic Hyperplasia Patients Permanently and Temporarily Unfit for Operation: An Analysis of 176 Cases

Abstract

During the four-year period 1962-1965, 553 patients underwent transvesicocapsular prostatectomy for benign prostatic hyperplasia. In 176 cases surgery was not primarily undertaken, but 76 of these patients were operated on at a later date, as a rule after existing contraindications had been eliminated. Twenty-one patients refused surgical treatment and 79 were judged to be permanently inoperable. The main reasons for this classification were severe senile dementia, advanced cardiovascular, pulmonary or renal disorders and advanced malignant disease. The patients were followed up for periods ranging from 4 years and 8 months to 8 months. At the end of that time 51 (65 per cent) of the permanently inoperable patients were dead, 14 (18 per cent) of the patients whose operation had to be delayed, and 2 (10 per cent) of the patients who refused surgery.

The permanently inoperable patients were on average older than the temporarily inoperable. Somatic contraindications to operation were more severe and less easily corrected in the very old patients and mental deterioration increased with age. Causes of death in the permanently inoperable group usually were the same as the reasons for inoperability. Deaths in the temporarily inoperable group, on the other hand, were only occasionally due to the factors that had caused postponement of prostatectomy.