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Purpose: We conducted a questionnaire survey to elucidate the rating of the patients who underwent transurethral resection of the prostate (TURP) and were managed by a common clinical path during hospitalization., Patients and Methods: At the day of discharge from seven hospitals in Japan, the questionnaires were handed to 298 patients who underwent TURP in 2002. In the path, it was determined that the patients should be admitted one day before surgery and discharged on the seventh postoperative day., Results: The questionnaires were returned by 240 (80.5%) patients. Of the 212 patients answering a question regarding the desirable preoperative hospital stay, 58 (27.4%), 85 (40.1%) and 46 (21.7%) considered 1, 2 and 3 days as a desirable preoperative stay, respectively. Of the 206 answering a question about the desirable postoperative hospital stay, 54 (26.2%), 28 (13.6%) and 60 (29.1%) considered 7, 8 and 9-10 days as a desirable postoperative hospital stay, respectively. Of the 240 patients, 229 (95.4%) received the path for the patients, 234 (97.5%) understood the treatment methods well and 229 (95.4%) understood the schedule during hospitalization well. Two hundred thirty-six (98.3%) and 218 (90.8%) patients answered that as scheduled, they started to have meals and started to walk, respectively. Continuous drip infusion was terminated in 219 (91.3%) as scheduled, and indwelling catheters were removed in 215 (89.6%) as scheduled., Conclusions: This questionnaire survey elucidated that approximately 70% of the patients who underwent TURP wanted to stay 1 or 2 days before surgery and 7 to 10 days after surgery. We consider it very important that patients understand well the treatment methods, complications, schedules during hospitalization and criteria for discharge when they are managed using the clinical path, so they will accept better a length of hospital stay that is shorter than that which they had desired.

Objective: We have the impression that the degree of obstruction was stronger in the patients with a middle lobe of hyperplastic nodule than in those without such a lobe in patients with benign prostatic hyperplasia. In the present study, we compared the data from a pressure-flow study (PFS) and a presence of a middle lobe., Materials and Methods: A transurethral resection for benign prostatic hyperplasia was performed in 2,439 patients, 798 underwent PFS. The PFS findings and the presence of a middle lobe were compared with the following parameters, namely, the bladder detrusor function, the degree of obstruction, the post-voided residual volume, the maximum flow rate, the prostate volume and the resected volume., Results: In the pressure-flow study, the rate of the normal bladder detrusor function was higher in the patients with a middle lobe than in those without such a lobe (71.9 versus 53.3%). The degree of obstruction was also stronger in the patients with a middle lobe than in those without in the patients with a normal bladder detrusor function (89.0 versus 79.4%). Then in the patients with a middle lobe, the quantity of the post-voided residual volume was greater, however, the maximum flow rate was lower., Conclusion: Most patients with a middle lobe demonstrate an improved voiding ability after underwent a transurethral resection.