Is Warm Temperature Necessary to Prevent Urethral Stricture in Combined Transurethral Resection and Vaporization of Prostate?

Park, Jong Kwan; Lee, Sang Kyi; Han, Suk Hee; Kim, Sang Deuk; Choi, Kwangseok; Kim, Myung Ki

doi:10.1016/j.urology.2008.12.057

Cited by 19 publications

(8 citation statements)

References 19 publications

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“…With the innovation of medicines including α-adrenergic blockers, 5α-reductase inhibitors, plant medicines, etc. medication has become the first-line therapy of LUTS/BPO gradually, especially in most developed countries ( 16 ). However, TURP still plays an important role in LUTS/BPO patients either being refractory to medication or having severe complications in some developing countries.…”

Section: Discussionmentioning

confidence: 99%

Analysis of risk factors leading to postoperative urethral stricture and bladder neck contracture following transurethral resection of prostate

Huang

Jiang

et al. 2016

Int. braz j urol.

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Purpose:To determine risk factors of postoperative urethral stricture (US) and vesical neck contracture (BNC) after transurethral resection of prostate (TURP) from perioperative parameters.Materials and Methods:373 patients underwent TURP in a Chinese center for lower urinary tract symptoms suggestive of benign prostatic obstruction (LUTS/BPO), with their perioperative and follow-up clinical data being collected. Univariate analyses were used to determine variables which had correlation with the incidence of US and BNC before logistic regression being applied to find out independent risk factors.Results:The median follow-up was 29.3 months with the incidence of US and BNC being 7.8% and 5.4% respectively. Resection speed, reduction in hemoglobin (ΔHb) and hematocrit (ΔHCT) levels, incidence of urethral mucosa rupture, re-catheterization and continuous infection had significant correlation with US, while PSA level, storage score, total prostate volume (TPV), transitional zone volume (TZV), transitional zone index (TZI), resection time and resected gland weight had significant correlation with BNC. Lower resection speed (OR=0.48), urethral mucosa rupture (OR=2.44) and continuous infection (OR=1.49) as well as higher storage score (OR=2.51) and lower TPV (OR=0.15) were found to be the independent risk factors of US and BNC respectively.Conclusions:Lower resection speed, intraoperative urethral mucosa rupture and postoperative continuous infection were associated with a higher risk of US while severer storage phase symptom and smaller prostate size were associated with a higher risk of BNC after TURP.

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Section: Discussionmentioning

confidence: 99%

Analysis of risk factors leading to postoperative urethral stricture and bladder neck contracture following transurethral resection of prostate

Huang

Jiang

et al. 2016

Int. braz j urol.

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“…Of the many complications of TURP, urethral stricture is the most serious complication, occurring in 1–30% patients after TURP, and it requires additional surgery or other interventions for management . To reduce the incidence of urethral stricture after TURP, several methods have been studied such as using a small‐diameter resectoscope or conducting TURP using warm saline . It has been reported that the incidence of urethral stricture is reduced by applying hyaluronic acid (HA) and carboxymethylcellulose (CMC), one of the anti‐adhesion agents, to the urethra after TURP .…”

Section: Introductionmentioning

confidence: 99%

Effects of poloxamer‐based thermo‐sensitive sol–gel agent on urethral stricture after transurethral resection of the prostate for benign prostatic hyperplasia: a multicentre, single‐blinded, randomised controlled trial

et al. 2019

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Objective To evaluate the effectiveness of poloxamer‐based thermo‐sensitive sol–gel instillation, after transurethral resection of the prostate (TURP), for preventing urethral stricture. Patients and Methods In all, 198 patients underwent TURP for benign prostatic hyperplasia. Recruited patients were randomly divided into two groups: groups A and B. Patients in Group A (100 patients, experimental group) received poloxamer‐based thermo‐sensitive sol–gel instillation and patients in the Group B (98 patients, control group) received lubricant instillation after TURP. Each patient was evaluated at 4 (V1), 12 (V2), and 24 weeks (V3) after TURP. The effectiveness of poloxamer‐based thermo‐sensitive sol–gel instillation was evaluated based on the International Prostate Symptom Score (IPSS), IPSS‐Quality of Life (QoL), Overactive bladder questionnaire (OAB‐q), maximum urinary flow rate (Qmax), post‐void residual urine volume (PVR), and cystoscopy. Results Amongst the initial 198 participants, 80 patients in Group A and 83 in Group B completed the study. There were no significant differences in IPSS‐QoL and OAB‐q between the groups. However, Qmax was significantly different between groups A and B, at a mean (SD) of 18.92 (9.98) vs 15.58 (9.24) mL/s (P = 0.028) at 24 weeks after TURP. On cystoscopic examination, urethral stricture after TURP was found in two of the 80 patients in Group A and 10 of 83 in Group B (P = 0.023). Conclusions Poloxamer‐based thermo‐sensitive sol–gel instillation after TURP lowered the incidence of urethral stricture.

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“…We observed that a lower temperature might be another cause of urethral stricture after TURP. The mechanical damage in the urethral mucosa leads to leakage of urine, resulting in inflammation and scar formation [17]. Resectoscope size, however, did not have a significant relationship with the incidence of urethral stricture.…”

Section: Discussionmentioning

confidence: 99%

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

Shin

Park

2011

Korean J Urol

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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.

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Is Warm Temperature Necessary to Prevent Urethral Stricture in Combined Transurethral Resection and Vaporization of Prostate?

Cited by 19 publications

References 19 publications

Analysis of risk factors leading to postoperative urethral stricture and bladder neck contracture following transurethral resection of prostate

Analysis of risk factors leading to postoperative urethral stricture and bladder neck contracture following transurethral resection of prostate

Effects of poloxamer‐based thermo‐sensitive sol–gel agent on urethral stricture after transurethral resection of the prostate for benign prostatic hyperplasia: a multicentre, single‐blinded, randomised controlled trial

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

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