Effect of transurethral split of the prostate using a double-columnar balloon catheter for benign prostatic hyperplasia

Abstract

We aimed to evaluate the long-term therapeutic effect of transurethral split of the prostate (TUSP) with a newly improved double-columnar balloon catheter on patients with benign prostatic hyperplasia (BPH).Total 565 BPH patients (mean age 73.6 years, range 46–94 years) who underwent TUSP surgery between January 2006 and January 2015 were included. Patient's baseline characteristics, prostate size, PSA, preoperative and postoperative maximum urinary flow rate (Qmax), postvoid residual (PVR), international prostate symptoms score (IPSS) and quality of life (QOL) score, perioperative data and postoperative complications were recorded.The mean preoperative prostates size was 48.6 ± 8.2 mL (range 33–230 mL), and the PSA level was 0.8 to 18.6 ng/mL. The mean duration of TUSP procedure from the catheter localization to the split of capsula prostatica was ∼10 minutes. After surgery, the mean Qmax increased from 5.2 ± 1.4 to 12.8 ± 2.2 mL/s (P < 0.001). Patients had improved mean PVR, QOL score, and IPSS after TUSP (76 ± 8 vs 20 ± 8.5 mL, 4.6 ± 0.2 vs 1.4 ± 0.3, and 20.2 ± 4.4 vs 6.6 ± 1.1, respectively, all P < 0.001). Until September 2014, 328 patients were successfully followed up for a long-term period of 38 to 99 months. There was no other case of recurrence with dysuria despite 2 recurrent cases.The TUSP with a double-columnar balloons catheter was a safe and long-term efficient treatment for BPH, with minimal invasion, short operative time, few postoperative complications, and low recurrence rate.

Efficacy and safety of transurethral split of prostate for benign prostatic hyperplasia: a meta-analysis

“…However, because this surgical method is relatively inexpensive and suitable for use in developing countries such as China, Huang [ 7 , 8 ] has improved TUDP and redesigned the balloon catheter. The new operation can crack the prostate capsule.…”

“…The catheter has no hemostatic function, so electrocoagulation hemostasis may be needed during the operation. Secondly, TUSP is unavailable for viewable operation [ 8 ], which may require further research and development of visual and automatic instruments. Finally, it is impossible to collect prostate tissue for histological examination because TUSP operation is performed while preserving prostate function [ 8 ].…”

“…After 328 patients were followed up for 38–99 months, Huang [ 8 ] found only 2 cases of recurrent dysuria, which showed that TUSP had a good long-term curative effect. However, due to the limited amount of literature, it is expected that more research on long-term linkages will be published in the future.…”

“…Professor Guo Yinglu from the First Hospital of Peking University, China, has been working on the transurethral split of prostate (TUSP) method for many years and finally developed a variety of models of double-chambered water balloon expansion catheters. They standardized the surgical procedure, making the surgery more mature in the treatment of BPH, and proved that the operation is safe and effective through related research [ 7 , 8 ].…”

A multicenter retrospective study of transurethral prostate split for benign prostate hyperplasia

“…Transurethral split of the prostate (TUSP) is an improvement on TUDP, mainly by replacing the spherical balloon with a double-column balloon catheter (18). TUSP dilates the prostatic urethra and bladder neck simultaneously with the aid of a double-column balloon catheter (19).…”