Changing profiles of patients undergoing transurethral resection of the prostate over a decade: A single-center experience

Abstract

Context: Patients with benign prostatic hyperplasia (BPH) usually form the bulk in urology outpatient departments. The management options include medical therapy or surgery. Transurethral resection of the prostate (TURP) has been the mainstay of surgical management. The use of medical therapy has increased over the years. This has led to a shift in the profiles of patients undergoing surgical management of BPH. Aims: We conducted this study to analyze the differences in profiles of patients undergoing TURP over a decade. Settings and Design: This was a retrospective study. Subjects and Methods: We retrospectively reviewed the medical records of all patients who underwent TURP from January 1 to December 31 in 2006 and 2016. The age, preexisting comorbidities, prostate volume, operative time, mean prostatic tissue removed, duration of hospitalization, and complications were evaluated among the two groups of patients. Charlson comorbidity index was used to evaluate the preexisting comorbidities, and the modified Clavien classification system was used for evaluating the perioperative and postoperative complications. Results: A total of 114 and 125 patients underwent TURP in 2006 and 2016, respectively. The mean age of the patients was 62.1 ± 8.22 and 66.94 ± 9.12 years in 2006 and 2016, respectively. The serum prostate-specific antigen levels increased from 4.39 ± 4.425 to 5.59 ± 7.61 ng/ml a decade apart. A number of patients taking medical therapy before surgical intervention increased from 62.23% to 75.2% ( P < 0.05). There was a significant increase in the mean prostatic volume and weight. There was only a modest increase of 1.94% in the total number of complications ( P > 0.05) and no significant change in the rates of complications. Conclusions: Medical therapy for BPH patients has resulted in delayed surgical interventions. The complication rates have not increased. Thus, the increased use of medical therapy in BPH patients is justified though TURP may still be considered the gold standard.

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

“…It should be noted that TURP syndrome remains a major concern. Triggered by excessive absorption of glycine (the electrolyte-free irrigation fluid utilized only in the monopolar energy system 11 ), this syndrome can significantly impact patients’ length of stays. With that said, TURP syndrome occurrence has dwindled in recent years, with incidence rates ranging between 0.78% and 1.4%.…”

“…For decades, transurethral resection of the prostate (TURP) has been a dominant surgical treatment for BPH. 11 It is estimated that approximately 150,000 TURP procedures are performed annually in the United States. 12 Despite numerous innovative alternatives, the impressive 90% success rate, high cost-effectiveness, and short learning curve have kept it as the first-line choice for prostates up to 80 mL in recent guidelines.…”

Early Removal of Foleys Catheter within 48 Hours of Transurethral Resection of the Prostate

“…Follow up after TURP is done using uroflowmetry and IPSS. 8 According to the literature average hospital stay after TURP is 2-7 days with average accommodation cost of 29-33%. So if any method can reduce hospital stay will minimize cost of the procedure.…”