 Preoperatively, all patients were thoroughly evaluated by medical history and physical exam, digital rectal exam DRE, prostate specific antigen PSA, urinalysis and urine culture, international index of prostate symptom score IPSS, Quality of Life QOL, transrectal ultrasound TRUS measurement of prostatic volume and biopsy whenever indicated, measurement of post-void residual assessment PVR, and maximum urinary flow rate Qmax. Preoperative flexible urethrocystoscopy was done when hematuria was the presenting symptom. 