ABSTRACT
Open prostate surgery is the oldest definitive surgical therapy for benign prostatic hyperplasia. From its infancy it became rapidly established in the early part of the 20th century and reached the peak of its popularity by the middle of the century. The technique of open prostatectomy can be broadly categorized into transvesical or retropubic, each described in turn by notable Irish surgeons. The vast majority of data used to compare the outcome of open prostatectomy with transurethral resection of the prostate is retrospective and must be considered to be of poor quality. Urodynamic investigation of postprostatectomy incontinence in 68 men has shown that sphincter damage plays a role in 69% of men with incontinence, but is the sole factor in only 27%. Open prostatectomy continues to constitute a very reasonable treatment strategy for men with large-volume prostates and those unsuited for transurethral surgery. This surgery should be considered safe, with complication rates comparable to the transurethral alternative.
