Long-Term Clinical Reliability of
Transurethral and Open
Prostatectomy for Benign
Prostatic Obstruction:
A Term of Comparison for
Nonsurgical Procedures

Montorsi, Francesco; Guazzoni, Giorgio; Bergamaschi, F.; Consonni, P.; Matozzo, Vincenzo; Barbieri, Luigi; Rigatti, Patrìzio

doi:10.1159/000474610

Cited by 19 publications

(9 citation statements)

References 17 publications

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“…One would assume that if the e¡ect on obstruction afterTURP is signi¢cantly higher than afterTUMT, then an exclusion of low-obstructed patients may give us a better outcome afterTURP. Generally, the outcome of transurethral surgery for LUTS is favorable in 60^95% of patients [Nielsen et al, 1989;Montorsi et al, 1993;Jensen et al, 1996]. In our study, at 8 years of follow-up the retreatment rate after TURP was 11%, complications appeared in 24% and 94% of the patients claimed satisfaction with this treatment choice.…”

Section: Discussionsupporting

confidence: 49%

TURP and low‐energy TUMT treatment in men with LUTS suggestive of bladder outlet obstruction selected by means of pressure‐flow studies: 8‐year follow‐up

Veselý

Knutson

Damber

et al. 2006

Neurourology and Urodynamics

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Section: Discussionsupporting

confidence: 49%

TURP and low‐energy TUMT treatment in men with LUTS suggestive of bladder outlet obstruction selected by means of pressure‐flow studies: 8‐year follow‐up

Veselý

Knutson

Damber

et al. 2006

Neurourology and Urodynamics

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“…11 About 20% of patients with symptomatic BPH have to be operated on primarily or secondarily after unsuccessful medical treatment, 7 and patients with severe preoperative symptoms benefit most from surgery. 12 In addition to providing improvement of symptoms and flow rates, TURP-unlike many alternative treatment modalities-includes histopathological analysis of the resected tissue.…”

Section: Resultsmentioning

confidence: 99%

Safer Transurethral Resection of the Prostate:: Coagulating Intermittent Cutting Reduces Hemostatic Complications

et al. 2004

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Purpose: Transurethral resection of the prostate (TURP) is still the gold standard for the surgical treatment of symptomatic benign prostatic hyperplasia. However, the associated morbidity and blood loss remain concerns. A coagulating intermittent cutting (CIC) device with constant voltage pulses and controlled pulse intervals was recently developed. The impact of CIC on bleeding and blood transfusion rates as well as the occurrence of the TUR syndrome were investigated.Materials and Methods: From January 2000 to July 2002, 271 consecutive patients with symptomatic benign prostatic hyperplasia underwent TURP with the CIC device. In addition to blood transfusion rates, serum hemoglobin and electrolytes were determined in all patients immediately before and after TURP.Results: The mortality rate in the 271 patients subjected to TURP was 0.0%. Mean decrease in hemoglobin after TURP was 1.08 mg/dl. Intraoperative and postoperative blood transfusions were required in 7 patients (2.6%), and clinical signs of the transurethral resection syndrome were noted in 1.1% of patients.Conclusions: Coagulating intermittent cutting dramatically improves the safety of TURP by decreasing intraoperative and postoperative blood loss, and the rate of blood transfusions. With this blood sparing device we anticipate a lower incidence of hemostatic complications from TURP.KEY WORDS: transurethral resection of prostate, blood transfusion, prostatic hyperplasia Transurethral resection of the prostate (TURP) is still the gold standard for the surgical management of symptomatic benign prostatic hyperplasia and has proven to be a highly efficient technique associated with a low mortality rate. 1-3 Despite technical advances in the last few years, morbidity associated with this technique has remained constant in the range of 15% to 18%, 1, 2, 4 -6 and intraoperative blood loss and the transurethral resection syndrome (the TUR syndrome) remain concerns. In 1996 we reported on 1,211 patients undergoing TURP with a standard 24Fr low-pressure continuous flow resectoscope, 7.6% of whom required blood transfusions due to intraoperative blood loss and/or postoperative bleeding which occurred up to 4 weeks after TURP. 2 To minimize the risk of bleeding a blood sparing device based on innovative high frequency technology was developed by Hartung et al. 6 With this device each cut results in an efficient coagulation zone in the tissue without impairing the cutting quality. 6 -8 In this study we evaluated bleeding and blood transfusion rates as well as the occurrence of the TUR syndrome in TURP performed with the new coagulating intermittent cutting (CIC) high frequency generator, and compared these rates with previous results of TURP performed with standard equipment, in particular our own retrospective data on the 1,211 consecutive patients who underwent standard TURP

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“…Drawbacks of traditional monopolar TURP include poor visibility, thermal injury, excessive bleeding, prolonged hospitalization and TUR syndrome, which may occur because of absorption of hypotonic fluid, particularly if the resection time exceeds 1 h [1] . In operations with larger prostates, the risk of complications depends mainly on the experience of the surgeon.…”

Section: Discussionmentioning

confidence: 99%

Catheter-Assisted Transurethral Resection of the Prostate: A Novel Approach

Shih¹,

Chow²,

Huang³

et al. 2008

Urol Int

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Introduction: The aim of the study was to compare the safety and efficacy of catheter-assisted transurethral resection of the prostate (TURP) with traditional TURP in the treatment of benign prostatic hyperplasia. Materials and Methods: A total of 61 men were randomized to either catheter-assisted TURP (30 patients) or traditional TURP (31), both performed with a monopolar device. Measurements included the duration of Foley catheterization, length of hospital stay, symptom score and urinary flow rate. All patients were followed for at least 1 year after surgery. Results: The catheter-assisted group had a significantly shorter operative time, duration of postoperative catheterization and length of stay. There were no significant differences in changes in serum sodium and hemoglobin level on postoperative day 1. At 1 year postoperatively, none of the patients suffered from urethral stricture and the 2 groups did not differ significantly in terms of prostatic volume, peak flow rate or International Prostate Symptom Score. Conclusions: Catheter-assisted TURP is safe and produced results at 1 year similar to traditional TURP. This new method for TURP appears to be a better and more effective approach than the traditional method, although a longer period of observation is needed to assess the durability of the results.

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Long-Term Clinical Reliability of Transurethral and Open Prostatectomy for Benign Prostatic Obstruction: A Term of Comparison for Nonsurgical Procedures

Cited by 19 publications

References 17 publications

TURP and low‐energy TUMT treatment in men with LUTS suggestive of bladder outlet obstruction selected by means of pressure‐flow studies: 8‐year follow‐up

TURP and low‐energy TUMT treatment in men with LUTS suggestive of bladder outlet obstruction selected by means of pressure‐flow studies: 8‐year follow‐up

Safer Transurethral Resection of the Prostate:: Coagulating Intermittent Cutting Reduces Hemostatic Complications

Catheter-Assisted Transurethral Resection of the Prostate: A Novel Approach

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