Perioperative management of transurethral surgery for benign prostatic hyperplasia: A nationwide survey in Japan

Okamura, Kikuo; Nojiri, Yoshikatsu; Seki, Nobuhiko; Arai, Yoichi; Matsuda, Tadashi; Hattori, Ryohei; Hasegawa, Tomonori; Naito, Seiji

doi:10.1111/j.1442-2042.2010.02712.x

Cited by 22 publications

(23 citation statements)

References 15 publications

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“…TUEB was developed to maintain the equivalent effi cacy of adenoma enucleation, such as open prostatectomy or HoLEP, with excellent haemostasis. According to a nationwide survey in Japan, which investigated the trend in surgical procedures for BPH in 2009 including 20 413 operations, endosurgical enucleation, such as HoLEP and TUEB, has dramatically increased, becoming the second most common treatment ( n = 3416; 16.7%) after standard TURP and TURis ( n = 14 799; 72.5%) [ 20 ] .…”

Section: T U E B a N D T R A N S U R E T H R A L R E S E C T I O N I mentioning

confidence: 99%

Comparison of transurethral enucleation with bipolar and transurethral resection in saline for managing benign prostatic hyperplasia

et al. 2012

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Study Type – Therapy (case series)Level of Evidence 4What's known on the subject? and What does the study add?Transurethral enucleation with bipolar (TUEB) has been widely adopted as an alternative to standard TURP, although the surgical technique, efficacy and safety of TUEB have not been described so far.The present study provides illustrations of the TUEB technique, as well as peri‐operative, 6‐month and 12‐month follow‐up results of TUEB from a retrospective review of a single‐institution experience comparing the efficacy and safety of TUEB and transurethral resection in saline for managing BPH.OBJECTIVE To illustrate the transurethral enucleation with bipolar (TUEB) technique and compare the efficacy and safety of TUEB and transurethral resection in saline (TURis) for managing benign prostatic hyperplasia (BPH). PATIENTS AND METHODS A retrospective review of a single‐institution experience of 110 consecutive TUEB or TURis between 2008 and 2011 at our hospital was performed aiming to compare the efficacy and safety of TUEB and TURis for managing BPH (55 patients in each group). Peri‐operative data included operating time, resected tissue weight, changes in haemoglobin, duration of catheterization, hospital stay and early complications. Postoperative outcomes included 6‐ and 12‐month postoperative International Prostate Symptom Score (IPSS), and Quality of Life (QoL) score, uroflowmetry findings, change in serum prostate‐specific antigen level and all late complications in the two groups. RESULTS Both groups were well matched for age, preoperative prostate volume, IPSS, QoL and uroflowmetry findings. The change in haemoglobin at postoperative day 1 in the TUEB group was significantly less than in the TURis group (1.08 vs 1.60 g/dL; P < 0.001). Catheterization time and hospital stay were significantly shorter in the TUEB group than in the TURis group and the mean retrieved tissue weight in the TUEB group was larger than that in the TURis group (41.3 vs 31.7 g; P= 0.007). Patients in the two arms had comparable improvements in postoperative IPSS, QoL, maximum flow rate and postvoid residual urine volume. The rates of complications were equally low with each procedure. CONCLUSION TUEB is superior to TURis, with less bleeding, as well as decreased catheter time and hospital stay, although showing equivalent efficacy at 12 months of follow‐up.

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Section: T U E B a N D T R A N S U R E T H R A L R E S E C T I O N I mentioning

confidence: 99%

Comparison of transurethral enucleation with bipolar and transurethral resection in saline for managing benign prostatic hyperplasia

et al. 2012

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“…For example, Japan is characterized by a longer length of stay for acute care patients compared with Western countries. 27,28 A survey on perioperative management of TURP around 2007 in Japan 29 reported that the postoperative length of stay for M-TURP and TURis was 8.3 -7.8 and 7.1 -3.6 days, respectively, and documented that most Japanese patients want to stay hospitalized until their urinary catheter is removed, because the national health insurance system covers these long postoperative stays.…”

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confidence: 99%

In-Hospital Outcomes and Cost Assessment Between Bipolar Versus Monopolar Transurethral Resection of the Prostate

Sugihara

Yasunaga

Horiguchi

et al. 2012

Journal of Endourology

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Purpose: We compared the in-hospital outcomes between bipolar and monopolar transurethral resection of the prostate (B-TURP and M-TURP, respectively) on a real-world practice using a large database. Patients and Methods: Patients who underwent TURP were extracted from the Diagnosis Procedure Combination database, which is a case-mix administrative claims database in Japan. TURP procedures were classified into M-TURP and B-TURP groups according to intraoperative use or nonuse of D-sorbitol solution, respectively, which is the only nonelectrolyte bladder irrigation fluid for M-TURP available in Japan. To exclude causality among autologous and homologous transfusion events, we confined eligible hospitals to those in which no autologous blood preparation was undertaken for TURP and whose annual surgical caseloads were 15 cases or more. Multivariate analyses were conducted for homologous transfusion, postoperative complications, operative time, postoperative length of stay, and total costs. Results: There were 5155 M-TURP and 1531 B-TURP patients identified. The results for M-TURP vs B-TURP (effect sizes were evaluated with reference to M-TURP) were 2.3% vs 1.3% for transfusion (odds ratio [OR] = 0.54; P = 0.013), 3.3% vs 1.7% for postoperative complications (OR = 0.46; P < 0.01), 98 vs 116 minutes for operative time (20.5% increase; P < 0.001), 8.65 vs 8.45 days for postoperative stay (3.6% reduction; P = 0.003), and $6103 vs $6062 for cost (1.7% reduction; P = 0.018). Conclusion: B-TURP had significantly lower rates of transfusion and postoperative complications, but a longer operative time. The impacts of B-TURP on shortening the hospital stay and lowering the costs were of little clinical significance.

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“…Reports on the incidence of recatheterization after surgery for treatment of BPH have varied. Failure to void after TURP is reported to occur in 0.5% to 21% of patients [6-12]. Failure to void after HoLEP is reported to occur in 1.4% to 12.1% of patients [12-17].…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of recatheterization after TURP has been reported as 0.5% to 21% of patients [6-12], and that after HoLEP has been reported as 5% to 9% [12-17]. Because of increased patient discomfort, increased duration of hospitalization, and risk of secondary urinary tract infection [18] caused by the catheter, recatheterization is a complication that surgeons want to avoid.…”

Section: Introductionmentioning

confidence: 99%

Relationship of Postoperative Recatheterization and Intraoperative Bladder Distention Volume in Holmium Laser Enucleation of the Prostate for Benign Prostatic Hyperplasia

et al. 2013

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PurposeThe purpose of this study was to identify the risk factors for recatheterization after holmium laser enucleation of the prostate (HoLEP).Materials and MethodsA total of 166 consecutive patients treated with HoLEP by a single surgeon from January 2010 to June 2011 were enrolled in this study. We collected data on preoperative and intraoperative parameters, including intraoperative bladder distention volume. The patients were divided into two groups. Group 1 included patients who voided successfully after removal of the catheter, and group 2 included patients who required recatheterization. Analysis and comparison of the perioperative parameters of both groups was performed for identification of risk factors for recatheterization.ResultsRecatheterization was required in 9 of 166 (5.4%) patients. No significant differences in age or preoperative parameters, including prostate-specific antigen, prostate volume, International Prostate Symptom Score, peak flow rate, postvoid residual urine, maximal bladder capacity, and Abrahams Griffiths number, were observed between the two groups. Of the intraoperative parameters, intraoperative bladder distention volume was significantly smaller in group 1 than in group 2 (700.65 mL vs. 897.78 mL, p<0.001). In the multivariate logistic regression analysis, after adjustment for other variables, intraoperative bladder distention volume was found to be a statistically significant risk factor for postoperative recatheterization (hazard ratio, 1.006; confidence interval, 1.002 to 1.010; p=0.002).ConclusionsNine of 166 (5.4%) patients failed to void after HoLEP and required catheterization. Intraoperative bladder distention volume was found to be a statistically significant risk factor for recatheterization in this patient group.

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Perioperative management of transurethral surgery for benign prostatic hyperplasia: A nationwide survey in Japan

Cited by 22 publications

References 15 publications

Comparison of transurethral enucleation with bipolar and transurethral resection in saline for managing benign prostatic hyperplasia

Comparison of transurethral enucleation with bipolar and transurethral resection in saline for managing benign prostatic hyperplasia

In-Hospital Outcomes and Cost Assessment Between Bipolar Versus Monopolar Transurethral Resection of the Prostate

Relationship of Postoperative Recatheterization and Intraoperative Bladder Distention Volume in Holmium Laser Enucleation of the Prostate for Benign Prostatic Hyperplasia

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