Early outcome of transurethral enucleation and resection of the prostate versus transurethral resection of the prostate

Abstract

INTRODUCTIONRecurrent prostate adenoma is a long-term complication following transurethral resection of the prostate (TURP). Transurethral enucleation and resection of the prostate (TUERP) is more appealing, since the nodular adenoma can be completely removed through endoscopy. TUERP is also hypothesised to result in a lower frequency of recurrent adenoma. This study aimed to compare the early outcomes of TUERP and TURP, and assess the feasibility and safety of TUERP. METHODSWe compared the outcome of 81 patients who underwent TUERP with that of 85 patients who underwent TURP. International prostate symptom score, quality of life score, prostate volume, degree of intravesical prostatic protrusion, maximum flow rate, post-void residual volume and prostate-specific antigen (PSA) level were obtained pre-and postoperatively. Complications (e.g. transfusion rate, incontinence, infection and urethral stricture) were analysed. RESULTSOperative time was significantly longer in the TUERP group compared to the TURP group (85.3 minutes vs.51.6 minutes). After TUERP, the maximum flow rate was significantly higher (21.1 mL/s vs. 17.1 mL/s) and PSA level was significantly lower (1.2 ng/mL vs. 1.9 ng/mL) than after TURP. The rates of infection, transfusion and urethral stricture were similar for both groups, but the TUERP group had a higher rate of temporary incontinence (13.6% vs. 4.7%). CONCLUSIONThe lower PSA level and better maximum flow rate achieved following TUERP suggest that prostate adenoma removal was more complete with TUERP. Long-term follow-up is required to establish whether TUERP results in fewer resections for recurrent adenoma. Keywords: benign prostatic hyperplasia, transurethral enucleation and resection of prostate, transurethral resection of prostate

Healthcare-Associated Infections after Lower Urinary Tract Endoscopic Surgery: Analysis of Risk Factors, Associated Microorganisms and Patterns of Antibiotic Resistance

“…UTI incidence after HoLEP ranges from 0 to 6.7% and severe sepsis or acute epididymitis are rare (1%) [17]. Acute urine retention was a predisposing ­factor because it could determine indwelling catheter [18].…”

Factores de riesgo asociados a complicaciones perioperatorias en la resección transuretral de próstata con bipolar. Revisión narrativa de la literatura

“…A pesar de que la HBP recurre hasta en el 7 % de los pacientes entre los primeros 8 a 22 años posterior a la RTUP, solo el 5,8 % requiere intervención en los siguientes 5 años, y el 6 % a los 10 años (15,22). Tasas mayores, de hasta el 15 % puede ser reportadas debido a una resección inadecuada del gran adenoma prostático durante la cirugía inicial (50).…”

Transurethral Enucleation and Resection of the Prostate: Contemporary Role in the Surgical Treatment of Benign Prostatic Hyperplasia

“…The type and rate of those complications depend on several factors including prostate size, comorbidities, duration of surgery, type of electro-cautery and surgeon's experience. These complications include TURS, infection, bleeding requiring blood transfusion, urethral stricture, bladder neck contracture, reoperation and transient incontinence [29,32,33].…”

“…One of the most commonly reported TUERP complications is transient incontinence, which occurs in 4.7%-17% of cases [28,[32][33][34]. Although stress type has been reported, urge-related incontinence was more common in the majority of cases [28,32]. Nevertheless, almost all patients experience gradual improvement over a period of 3-6 months [32,33].…”