Simultaneous Transurethral Resection of Bladder Tumor and Benign Prostatic Hyperplasia: Hazardous or A Safe Timesaver?

Abstract

Our data indicate that simultaneous TURBT and TURP do not negatively affect tumor recurrence at the bladder neck and prostatic urethra.

Outcome of Simultaneous Transurethral Resection of Bladder Tumor and Transurethral Resection of the Prostate in Comparison with the Procedures in Two Separate Sittings in Patients with Bladder Tumor and Urodynamically Proven Bladder Outflow Obstruction

“…16,23,24 These studies included a relatively large number of patients and demonstrated that performing synchronous TURP along with TURBT did not increase the rates of recurrence in the prostatic fossa. [3][4][5]14,15 These studies emphasized that the two operations could be performed during the same session without any negative oncologic results. None of these studies were randomized, however, and thus missed the opportunity of making a strong statistical argument in favor of simultaneous resection of both pathologic conditions.…”

“…This hypothesis, however, could not be verified in other comparative studies. [3][4][5]14,15 The safety issue of simultaneous TURP with TURBT remains unclear. Findings in the present study demonstrate that most of the recurrences were not at the primary site of resection (including the prostatic fossa) ( Table 3).…”

“…1,2 The high recurrence rate might be explained by multicentricity of tumors, continued exposure to urinary carcinogens, the propensity of the patients' urinary epithelium to form neoplastic tissue, and=or tumor cell dissemination during transurethral resection. [11][12][13][14][15] The presumed pathways for this dissemination are extravasation of the irrigation fluids by way of blood or lymphatic circulation and=or implantation of tumor cells at the traumatized sites because of the high intravesical pressures generated during transurethral resection. 6,7,16,17 A greater number of recurrences have been shown to develop on the posterosuperior wall, which is probably the most frequent site to be traumatized during TURBT.…”

Comparing the treatment outcomes of potassium‐titanyl‐phosphate laser vaporization and transurethral electroresection for primary nonmuscle‐invasive bladder cancer: A prospective, randomized study

“…After endoscopic surgeries, the reduction of recurrence rate remains a great challenge to the urologists in the treatment of superficial bladder cancer . There are several theories for explaining the high replase rate of NMIBT following transurethral resection, including tumor multicentricity, incomplete tumor resection, and intraoperative dissemination of tumor cells . During the TURBT procedure, tumor cells may seed into the washing fluid and implant in denuded or injured bladder mucosa leading to replase of tumor, especially in the back and dome of the bladder wall .…”

Simultaneous Transurethral Resection of Bladder Tumour and Prostate: Is It Safe?

“…The authors advised against simultaneous TURBT and TURP. The second and more recent single-arm study, by Tsivian et al [6] , reported on 51 men treated with TURBT and TURP at the same time; 11 (22%) developed recurrence(s) at the bladder neck and prostatic urethra, but the true recurrence rate was 14%, since the primary tumour was located on the bladder neck in 4 of the 11 patients. Six of the remaining 7 had multifocal recurrences in other parts of the bladder.…”