Indications for Surgical Management of Benign Prostatic Hyperplasia

Abimbola, Obafunbi; Raynor, Mathew C.

doi:10.1007/978-3-030-23471-3_4

Cited by 2 publications

(1 citation statement)

References 48 publications

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“…Indications for surgical intervention encompass refractory LUTS, recurrent urinary retention, urinary tract infections, refractory gross hematuria, obstructive uropathy, and the presence of bladder stones. 9 , 10 …”

Section: Introductionmentioning

confidence: 99%

Transurethral Resection of the Prostate in Younger Men: Effectiveness and Long-term Outcomes

Malshy,

Eigner,

Ochsner

et al. 2024

Rambam Maimonides Med J

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Objectives: This study aims to investigate the efficacy and outcomes of transurethral resection of the prostate (TURP) in the context of younger male patients. Methods: Males aged ≤55 who underwent TURP at Rambam Health Care Campus from January 2011 to August 2023 were retrospectively reviewed. Clinicodemographic characteristics, indications for surgery, uroflowmetry, pressure-flow study, and early and late postoperative outcomes were collected. Patients with urethral or bladder abnormalities were excluded. Chi-square and Fisher’s exact tests were employed for bivariate analysis. Results: Inclusion criteria were met by 58 men who underwent TURP at a median age of 52 years (interquartile range [IQR] 49.5–54). Median prostate size was 35 mL (24.5–56), with median prostate-specific antigen of 1.4 ng/mL (0.65–3.1). A total of 60% of patients used α-blockers, and 19% used 5α-reductase inhibitors pre-surgery. Overall, 54 (93.1%) had severe lower urinary tract symptoms (LUTS), with 34 (59%) being predominantly emptying and 20 (35%) storage. Most surgeries were performed for refractory LUTS in 38 (66%), followed by urinary retention in 16 (28%). At 6 weeks, 57 (98%) patients were catheter-free. The maximum flow rate and residual volume showed significant improvement from 9 mL/s to 21 mL/s (P=0.01), and from 171 mL to 61 mL (P=0.006), respectively. Pathology revealed benign prostatic hyperplasia in 53 (91.4%), and inflammation in 5 (8.5%). A total of 13 auxiliary procedures were required in 12 patients (20.7%) during follow-up: 7 transurethral bladder neck incisions, 3 re-TURP, 1 meatus widening, and 1 patient required artificial urinary sphincter implantation followed by simple cystectomy for end-stage bladder. Conclusions: In young men, TURP showed short-term gains in flowmetry and catheter removal rates, but a sustained need for subsequent procedures in the long run. In this unique population, patients should be carefully selected, and alternative, less aggressive, interventions should be considered.

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Section: Introductionmentioning

confidence: 99%

Transurethral Resection of the Prostate in Younger Men: Effectiveness and Long-term Outcomes

Malshy,

Eigner,

Ochsner

et al. 2024

Rambam Maimonides Med J

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Optimising postoperative care: Same-day discharge after transurethral resection of the prostate

Malshy,

Balen,

Golijanin

et al. 2024

Journal of Perioperative Practice

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Introduction: This study aims to assess the feasibility and safety of same-day discharge after transurethral resection of the prostate. Materials and Methods: Five years of records were retrospectively analysed. Length of stay categorised patients into Groups 1 (same-day discharge) and 2 (standard-length discharge). Logistic regression analysis was performed, controlling for clinicodemographic factors. Student’s t-test compared continuous bladder irrigation and catheter dwell times. Results: A total of 459 patients were identified between 2016 and 2021, 280 in Group 1 and 179 in Group 2, with median ages of 71.0 (interquartile range 36–92) and 72.0 (interquartile range 47–101) years (p = 0.067), respectively. Same-day discharge rates notably increased post-2018 (p = 0.025). Median prostate tissue resected in Group 2 was 7.1g (3.4–12.4g) and in Group 1 was 4.9g (2.4–10.2g; p = 0.034). While continuous bladder irrigation >1 hour was significantly lower in Group 1 than Group 2 (96.8% versus 27.4%; p = 0.0001), catheter dwell times were comparable (70.1 and 70.8 hours, respectively). Control-adjusted results showed a 40% reduction in emergency department representation odds for Group 1 compared with Group 2 (odds ratio = 0.60; 95% confidence interval = 0.37–0.99; p = 0.04). Length of stay was not significantly associated with hospital readmissions (p = 0.11). Continuous bladder irrigation for <1 hour in Group 1 was associated with a reduced emergency department representation (odds ratio = 0.43; 95% confidence interval = 0.197–0.980) but not readmission (odds ratio = 0.413; 95% confidence interval = 0.166–1.104). Conclusions: Same-day discharge post-transurethral resection of the prostate may be a viable and safe option for carefully selected patients.

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Indications for Surgical Management of Benign Prostatic Hyperplasia

Cited by 2 publications

References 48 publications

Transurethral Resection of the Prostate in Younger Men: Effectiveness and Long-term Outcomes

Transurethral Resection of the Prostate in Younger Men: Effectiveness and Long-term Outcomes

Optimising postoperative care: Same-day discharge after transurethral resection of the prostate

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