Changes in Surgical Strategy for Patients with Benign Prostatic Hyperplasia: 12-Year Single-Center Experience

Abstract

PurposeThe purpose of this study was to evaluate the annual changes in prostate variables and style of surgical treatment of patients with benign prostatic hyperplasia (BPH) over the past 12 years.Materials and MethodsThe subjects were 918 patients (January 1999-November 2010) who were treated by either open prostatectomy or transurethral resection of prostate (TURP). Every year, the performance ratio between open prostatectomy and TURP was evaluated. Before surgery, total and transitional zone volumes of the prostate were measured by transrectal ultrasonography (TRUS). After surgery, resection weight and residual volume of the prostate were measured by TRUS.ResultsFrom 2001 through 2010, the performance ratio of TURP increased greatly from 89% to 97%. During 1999 to 2010, the total volume of the prostate increased from 40.0 cc to 55.0 cc in the TURP group and from 74.1 cc to 116.7 cc in the open prostatectomy group. During 1999 to 2010, the mean resection volume of the TURP group increased from 2.3 cc to 20.1 cc. Also, the mean resection volume of the open prostatectomy group increased from 59.3 cc to 114.3 cc. During 1999 to 2003, the resection time of the TURP group decreased from 72.9 minutes to 43.2 minutes.ConclusionsDuring 1999 through 2010, the performance ratio between open prostatectomy vs TURP was high for TURP. The total volume and resection volume of the prostate increased annually, and the resection time decreased annually.

Examining the ‘gold standard’: a comparative critical analysis of three consecutive decades of monopolar transurethral resection of the prostate (TURP) outcomes

“…[1], reported mean resected tissue weight of 28.4 g in a large community cohort, suggesting that resection of larger prostates in the contemporary era was most likely. Shin and Park [9] have also reported an increase in the PV of their contemporary TURP series. Despite this, resected prostate weight increased and resection time decreased suggesting improved resection efficiency (resection volume per minute of TURP).…”

Impact of Changing Trends in Medical Therapy on Surgery for Benign Prostatic Hyperplasia Over Two Decades

“…This study showed that the mean prostate volume was significantly greater in group 3 than in group 1; simultaneously, the weight of the resected tissue was also significantly greater in subgroup 3 than in subgroup 1. Shin and Park [ 14 ] reported that the mean resection volume increased with both TURP and open prostatectomy between 1999 and 2010. Reich et al [ 15 ] evaluated 10,654 patients who underwent TURP and showed that mortality and morbidity were closely associated with the weight of tissue resected.…”

Current Status of Transurethral Prostatectomy: A Korean Multicenter Study

“…Patients treated by TURP show an increase in not only prostate volume but also resected prostate volume, which may be because the surgery was delayed by treatment with α-1 blockers or 5-α reductase inhibitors [ 16 ].…”