Prostatic Tissue Distal to the Verumontanum and Its Significance for Adenomatous Recurrences after Transurethral Resection of the Prostate

To elucidate possible causes of recurrences after transurethral resection of the prostate (TURP), we performed an anatomical study of the prostate in 37 cadavers. The anatomical study showed that a significant proportion of the prostatic adenoma laid below the verumontanum. This proportion in relation to the total prostatic length varied from 8.33 to 44.44%, while in relation to the weight it varied from 2.08 to 36.84%. After transurethral resection of the prostatic adenoma, part of the apical lobes below the verumontanum remains intact deliberately to secure continence. These adenomatous tissues left behind create the problem of the residual apical lobe. Recent reports in the literature have shown a higher incidence of prostatic adenomatous recurrences following TURP than after open prostatectomy. From our study and from an extended search in the literature, it seems that a possible reason for adenomatous recurrences can be due to the remaining residual apical lobes that are left behind after TURP, providing that the resection had been complete.