Benignes Prostatasyndrom (BPS)

Abstract

Today, the surgical treatment of the benign prostatic syndrome (BPS) often follows a course of drug treatment. Besides conventional transurethral resection of the prostate (TURP), which has represented the standard therapeutic option for decades, and its in part significant modifications ("vaporizing resection"; bipolar resection), much of the interest has shifted to alternative instrumental procedures like transurethral microwave therapy (TUMT), transurethral needle ablation of the prostate (TUNA) or several laser techniques. By reviewing the current literature, preferably from randomized controlled trials, these different procedures are critically assessed. Moreover, the present role of open prostatectomy is discussed.

Vaporization of prostates of ≥80 mL using a potassium‐titanyl‐phosphate laser: midterm‐results and comparison with prostates of <80 mL

“…It is very effective in experienced hands, with good tissue ablation and long-term results [1,6]. Nevertheless, certain complications are still associated with TURP, e.g.…”

“…Nevertheless, certain complications are still associated with TURP, e.g. fluid retention in about half of patients, and that are clinically relevant in 2-12% of the patients [1,13], and a transfusion rate of 5-11% [6].…”

“…perioperative haemorrhage or TUR syndrome [4], for the past 10-15 years research has been focused on new surgical (if possible transurethral) techniques that can remove sufficient prostatic tissue, avoiding open surgery and the classical risk factors of TURP [3]. Alternative treatment options are microwave therapy, high-intensity focused ultrasound, needle ablation and several forms of laser therapies [5][6][7][8][9].…”

TURP in the new century: an analytical reappraisal in light of lasers

“…7 More recently, Reich and colleagues published a contemporary prospective evaluation of 10 654 patients who underwent TURP statewide. 8 The mortality rate was 0.10% and the cumulative short-term morbidity rate was 11.1%; both rates continuously declined compared to a previous classical study by Mobust and colleagues of 3885 patients. 6 Complications of TURP include failure to void (4.5% to 5.8%), surgical revision (1.1% to 5.6%), urinary tract infection (3.6% to 4.2%), bleeding which requires transfusions (2.0% to 2.9%) and TUR syndrome (0.8% to 1.4%).…”

“…5 TURP has been demonstrated to be efficient, cost-effective and, most importantly, durable with low long-term complications and re-treatment rates. [6][7][8][9] The seminal multicentre randomized trial comparing TURP with watchful waiting demonstrated a 52% reduction in treatment failure in TURP, a 1% risk of urinary incontinence similar in the watchful waiting group, and an overall decline in sexual function identical to the watchful waiting group. 7 More recently, Reich and colleagues published a contemporary prospective evaluation of 10 654 patients who underwent TURP statewide.…”