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Transvesical prostatic adenomectomy: a modification of Lower, Harris, and Hryntschak techniques.

A review of 226 transvesical prostatic adenomectomies performed by a modification of Hryntschak's technique over a 13-year span is presented. The technique incorporates closure of the vesical neck with transverse sutures of 2-0 plain catgut around a plastic Foley catheter and primary closure of the cystotomy following routine adenoma enucleation. Hemostatic suturing of the posterior vesical neck before placement of the transverse vesical neck sutures is routinely omitted. The results have been uniformly good with low incidence of mortality and morbidity. The average operative blood loss was 761 ml and postoperative bleeding was minimal. This technique is safe, simple and requires an acceptable operating time.