الفهرس 
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Abstract
The senile prostatic enlargement represents one of the main
problems in old age, and it is estimated that every man over the age of
forty years, has some degree of senile prostatic enlargement.
The symptoms of senile prostatic enlargement are either
obstructive or irritative. They may be severe enough to interfere with
patient’s life and activities. Various modalities of treatment of S.P.E.
are UJW available:
1- Medical treatment, including Hormonal and non-Hormonal
treatment. The medical treatment is mainly indicated in poor risk
patients that can not tolerate any type of anaesthesia, in patients
waiting for operation to give symptomatic relief, in catheter wearer
to allow removal of the catheter, and may be given pre-and post.
Operatively to prevent post operative retention. Medical treatment
is not supposed to replace an indicated operation or to reduce the
prostatic size. It’s main use is in the early cases, with mild
symptoms and no complications.
2- The endoscopic manipulation, including transurethral resection and
prostatic incision. The transurethral resection depend mainly on
the availability of instruments and the experience of the surgeon. It
IS mainly indicated in a patient with definite, persistent, and
progressive symptoms, and gland that can be resected to the
surgical capsule in a reasonable lenght of time, and can not be
adequately enucleated by open morbidity, and mortality, and the
results of T.U.R. can never be achieved by open surgery in many
pathological conditions of the prostate and the bladder neck.
Surgical treatment, including the different approaches to the
prostate, the retropubic, the suprapubic and the perineal routes.
The retropubic approach affords direct exposure and better
haemostasis. It is indicated in very large glands and can be
resorted to when serious complications arise during T.U.R. The
Madigan prostatectomy is a type of retropubic prostatectomy in
which the prostatic urethra remain intact. Suprapubic approach is
especially indicated when vesical pathology is accompanying huge
prostatic enlargement. The different modalities of treatment are
tailored according to the patient’s general and urological condition,
the. size. and configurations of prostatic enlargement, the
accompanying vesical or urethral pathology, the availability of
instruments, and the experience of the surgeon.
In this work evaluation of the different methods of treatment had
been made.