Outcomes of Transurethral Resection of the Prostate in Benign Prostatic Hyperplasia Comparing Prostate Size of more than 80 Grams to Prostate Size less than 80 Grams

Abstract

Background

Comparison of Outcome after Transurethral Resection of Small Versus Large Prostate in Benign Prostatic Hyperplasia

“…The complications were comparable to Jordan experience, 11 however, the hospital stay was less as compared to 6.08 ±4.01 and 4.80 ±1.47 days in the previous study comparing small and large prostate TURP. 9 Transient incontinence for first three months was encountered in more than one-third (38%) patients after TURP in Romanian cohort, 10 however only 22% in our study had this problem which improved significantly by 1 year of follow-up. On long term follow-up, the large prostate cohort had a significant relief (p=0.000) in lower urinary tract symptoms, with IPSS scores at 1 year post-surgery comparable in both the groups (p=0.421).…”

“…11 The study from Jordan had reported 72 ±6.2 minutes resection time for sizes more than 80 grams, 11 and the series from Kathmandu had comparatively very high resection time for both small and large prostate groups (110 ±15 vs 90±20). 9 Longer resection time in large prostate volume subjects of our study meant more bleeding and greater fall in hemoglobin (p=0.016), and larger raw bleeding area requiring prolonged post-op catheterization till hemostasis was achieved (3.58 ±0.84 vs 2.15 ±0.36, p=0.000). The fall in hemoglobin in the large prostate group in our study (0.92 ±0.58 mg/dl) was less than that encountered by Al-Hammouri et al (3.2 ±0.6 mg/ dl) in same size group.…”

“…7 The trends in developed countries, like United States, are showing a sharp decline in the rate of TURP (81% to 39% from 1999 to 2005), due to advent of minimal invasive procedures, 8 but the developing world often faces compelling circumstances like limited infrastructural resources and poor patient affordability for laser procedures, besides the universal reluctance for open surgery and often have to go for TURP in all prostates sizes. A previous study has compared small number of patients, but had shorter follow-up 9 and another Romanian study has previously compared TURP with open prostatectomy in large prostate (with almost half of TURP procedures done as two stage procedures). 10 This prospective study has systematically compared the immediate, early and long-term outcomes after TURP in small (≤80grams) versus large (>80 grams) prostate.…”

“…Some previous studies have reported an incidence of post TURP urethral stricture from 2.2% to 9.2% and bladder neck contracture in 0.3 to 9.2%. 11,12,13,14 Joshi et al reported regular use of internal urethrotomy (Otis), 9 but still a post TURP urethral stricture occurred in 5.7% from small prostate, 9 and 6% in Jordan series of large prostate 11 who required further intervention by Optical Internal urethrotomy (OIU), which was hypothesized to be due to their prolonged operative time. There were no stricture urethra and bladder neck contractures on follow up in any of our patients.…”

Transurethral resection of the prostate versus prostatic artery embolization in the treatment of benign prostatic hyperplasia: a meta-analysis

“…Surgical treatments (transurethral resection of the prostate or open surgery) are used for treatment in the event of failed medical management [4]. Transurethral resection of the prostate (TURP) is considered the gold standard of treatment for men with prostate volumes of 30–80 ml, and it is also appropriate for those with prostate volumes > 80 ml [1, 5]. However, the complications of TURP include sexual dysfunction, retrograde ejaculation, postoperative hemorrhage, continent urinary retention, TURP syndrome and urinary stricture [6, 7].…”