The Madigan prostatectomy. A total of 59 patients with bladder outflow obstruction underwent the Madigan prostatectomy. The method, results and complications are described. For select patients with large benign adenomas without a median lobe or hematuria we believe the technique to be the operation of choice, particularly in younger patients. Advantages include absence of postoperative hematuria and clot retention, a decreased requirement for blood transfusions, a 16F postoperative catheter with early removal, avoidance of post-catheter stricture, a low rate of postoperative urinary infection, a short comfortable period of hospitalization and, in the long term (median followup 6 years), preservation of potency and antegrade ejaculation. 