When the patient is deemed fit for definitive treatment, the surgical procedure consists of the removal of the enlarged gland. Two operations are popular. Each carries its own merits and disadvantages.it's important for the treatment of Benign Prostatic Hypertrophy.

Millin's retropubic prostatectomy (1947) is done by approaching the prostate via the space between the prostate and the pubic bone through a suprapubic incision. Since the bladder is not opened, it must be preceded by cystoscopic examination to detect any concomitant lesions in the bladder. After enucleation of the enlarged lobe, the prostatic capsule is sutured back. Modified Freyer's transvesical prostatectomy is a welltried alternative.

The bladder is opened and the prostate enucleated after breaking through the prostatic urethral mucosa. Overhanging mucosa is excised. Haemostasis is secured by diathermy coagulation and/or suture. The bladder can be closed with a perivesical drain. Transvesical prostatectomy has the advantage of being able to deal with any other concomitant lesion in the bladder. Emergency prostatectomy (Wilson Hey, 1945) advocated by Wells (1952) takes little account of renal insufficiency and carries with it a higher mortality in average hands. (Lane, 1949).

Complications of Prostatectomy.

1. Haemorrhage.

2. Postoperative vesical fistula is not uncommon, but it is usually temporary. This occurs only in Freyer's Prostatectomy.

3. Urethral stricture with further obstruction. This is due to the overhanging mucosa at the internal sphincter. Its occurrence is prevented by trimming the mucosa and performing sphincterotomy at the time of surgery.

4. Epididymitis. Incidence reduced by vasectomy.

5. Osteitis pubis. This rare complication is encountered in Retropubic type of Prostatectomy. This has not occurred in our series.

Transurethral Resection is an operation that is especially popular in North America. A McCarthy or Nesbit resectoscope is the instrument commonly used. The prostatic adenoma is removed piecemeal.

In the presence of infection or renal insufficiency, it is contraindicated. Bacteraemia, septicaemia and intravascular haemolysis are complications. . In unfamiliar hands, rupture of the bladder or prostatic capsule is common.However, in the hands of experienced surgeons trained in this technique, it is an attractive operation with a short and comfortable postoperative convalescence. It is eminently suitable for the small and fibrous prostate.