Patient acceptability of transurethral incision of the prostate under local anaesthesia.

Abstract

To determine the acceptance by patients of transurethral incision of the prostate (TUIP) under local anaesthesia. The study comprised 30 consecutive patients who elected to undergo local anaesthesia for TUIP and were treated between December 1994 and September 1995. Twenty-two were considered a high risk for general anaesthesia and eight patients chose local anaesthesia for personal reasons. Patients were premedicated (opioid and benzodiazepine) and 1% lidocaine was infiltrated transurethrally using an endoscopic needle. The level of acceptance was determined using an immediate post-operative questionnaire which included a linear visual analogue scale (VAS) to rate pain. No patient required conversion to another type of anaesthesia and there were no complications related to the local anaesthesia. The mean (SE) VAS score was 3.2 (1.7) and the questionnaire results showed that 83% of the patients did not consider that general anaesthesia was necessary for the operation and that 90% would agree to undergo the procedure again under local anaesthesia. TUIP under local anaesthesia was well tolerated in motivated patients. We recommend it as the operation of choice for the relief of obstruction in high-risk patients with a small benign prostatic hyperplasia.