From gold standard to platinum standard in BPH surgery: a perspective from a tertiary care center of the Indian subcontinent

Authors

  • Rajeev T. P. Department of Urology, Gauhati Medical College Hospital, Guwahati, Assam, India
  • Yashasvi Singh Department of Urology, Gauhati Medical College Hospital, Guwahati, Assam, India
  • Sasanka Kumar Barua Department of Urology, Gauhati Medical College Hospital, Guwahati, Assam, India
  • Debanga Sarma Department of Urology, Gauhati Medical College Hospital, Guwahati, Assam, India
  • Manash Pratim Kashyap Department of Bussiness Administration, North Eastern Regional Institute of Management, Padma Nath Sarmah Bhawan, Khanapara, Guwahati, Assam, India

DOI:

https://doi.org/10.18203/2349-2902.isj20181137

Keywords:

Benign prostatic hyperplasia, Effective fasting glucose, Erectile dysfunction, Monopolar TURP

Abstract

Background: For last eight decades, transurethral resection of the prostate (TURP) has remained the mainstay of surgical treatment for BPH, due to the procedure’s excellent, well-documented and long- lasting treatment efficacy. Patients with clinically bothersome LUTS suggestive of BPH not relieved with medical treatment benefit from transurethral resection/vaporization of prostate using various energy sources. Monopolar TURP has been the main form of treatment for many years in men with BPH and remains the gold standard against which other treatments are evaluated. The aim of this article is to review the role of m-TURP in contemporary BPH management.

Methods: This retrospective study included 275 patients with bothersome LUTS and histologically confirmed BPH, who underwent m-TURP at Deprtment of Urology and Renal Transplantation between July 2010 and July 2015 and were in follow up for at least 24 months in the Urology OPD. The most frequent indication (50-60%) for TURP is LUTS refractory to medical therapy.

Results: A total of 274 patients were divided into 3 groups based on prostate volume of less than 40 gram (Group A), 40 to 80 grams (Group B) and more than 80gm (Group C). Statistically, deranged EFG was significantly associated and correlated with Group B). The mean preoperative hemoglobin level for the entire patient population was 13.14±1.26 whereas the post-operative hemoglobin level was 12.22±1.39gm/dl. Similarly, the mean preoperative sodium level for the entire patient population was 137±4.26 whereas the post-operative level was 130±5.04mEq/L.

Conclusions: M-TURP is adequate for its intended use as an effective learning tool and as a substantial practical tool for managing BPH; m-TURP results depend on surgeons’ experience, the patient’s prostate volume- and comorbidities.

References

Reich O, Gratzke C, Stief CG. Techniques and long-term results of surgical procedures for BPH. Eur Urol. 2006;49:970-8.

Rassweiler J, Teber D, Kuntz R. Complications of transurethral resection of the prostate (TURP)- incidence, management and prevention. Eur Urol. 2006;50:969-80.

Mebust WK, Holtgrewe HL, Cockett AT, Peters PC, Bueschen AJ, Carlton Jr CE, et al. Transurethral prostatectomy: immediate and postoperative complications. A cooperative study of 13 participating institutions evaluating 3,885 patients. The Journal of urology. 1989 Feb 1;141(2):243-7.

Rassweiler J, Teber D, Kuntz R, Hofmann R, Puppo P. Complications of transurethral resection of the prostate (TURP)-incidence, management, and prevention. European urology. 2006;50(5):969-80.

Yu X, Elliott SP, Wilt TJ, McBean AM. Practice patterns in benign prostatic hyperplasia surgical therapy: the dramatic increase in minimally invasive technologies. J Urol. 2008;180:241-5.

Ho HS, Yip SK, Lim KB, Fook S, Foo KT, Cheng CW. A prospective randomized study comparing monopolar and bipolar transurethral resection of prostate using transurethral resection in saline (TURIS) system. Eur Urol. 2007;52:517-22.

Tascı AI, Ilbey YO, Tugcu V, Cicekler O, Cevik C, Zoroglu F. Transurethral resection of the prostate with monopolar resectoscope: single-surgeon experience and long-term results of after 3589 procedures. Urol. 2011;78:1151-5.

Hu Y, Dong X, Wang G, Huang J, Liu M, Peng B. Five-year follow-up study of transurethral plasmakinetic resection of the prostate for benign prostatic hyperplasia. J Endourol. 2016;30:97-101.

Neyer M, Reissigl A, Schwab C. Bipolar versus monopolar transurethral resection of the prostate: results of a comparative, prospective bicenter study perioperative outcome and long-term efficacy. Urol Int. 2013;90:62-7.

Erturhan S, Bayrak Ö, Seçkiner İ, Demirbağ A, Erbağcı A, Yağcı F. Comparative outcomes of plasmakinetic versus monopolar transurethral resection of benign prostatic hyperplasia: 7 years’ results. Turkish journal of urology. 2013 Dec;39(4):220.

Fagerström T, Nyman CR, Hahn RG. Complications and clinical outcome 18 months after bipolar and monopolar transurethral resection of the prostate. Journal of endourology. 2011 Jun 1;25(6):1043-9.

Muslumanoglu AY, Yuruk E, Binbay M, Akman T. Transurethral resection of prostate with plasmakinetic energy: 100 months results of a prospective randomized trial. BJU Int. 2012;110:546-9.

Koca O, Keleş MO, Kaya C, Güneş M, Öztürk M, Karaman Mİ. Plasmakinetic vaporization versus transurethral resection of the prostate: Six-year results. Turkish J Urol. 2014 Sep;40(3):134.

Thangasamy IA, Chalasani V, Bachmann A, Woo HH. Photoselective vaporisation of the prostate using 80-W and 120-W laser versus transurethral resection of the prostate for benign prostatic hyperplasia: a systematic review with meta-analysis from 2002 to 2012. Eur Urol. 2012;62:315-23.

Ahyai SA, Gilling P, Kaplan SA, Kuntz RM, Madersbacher S, Montorsi F, et al. Meta-analysis of functional outcomes and complications following transurethral procedures for lower urinary symptoms resulting from benign prostatic enlargement. Eur Urol. 2010;58:384-97.

Thomas AW, Cannon A, Bartlett E, Ellis-Jones J, Abrams P. The natural history of lower urinary tract dysfunction in men: minimum 10–year urodynamic follow up of transurethral resection of prostate for bladder outlet obstruction. J Urol. 2005;174:1887-91.

Ameda K, Koyanagi T, Nantani M, Taniguchi K, Matsuno T. The relevance of preoperative cystometrography in patients with benign prostatic hyperplasia: correlating the findings with clinical features and outcome after prostatectomy. J Urol. 1994;152:443-7.

Illing R. Surgical and minimally invasive interventions for LUTS/BPH: highlights from 2006. European Urology Supplements. 2007;6:701-9.

Reich O. Bipolar transurethral resection of the prostate: what did we learn, and where do we go from here? Eur Urol. 2009;56:796-7.

Milonas D, Matijošaitis A, Jievaltas M. Transition zone volume measurement - is it useful before surgery for benign prostatic hyperplasia? Medicina (Kaunas). 2007;43:792-7.

Finkle AL, Moyers TG, Tobenkin MI, Karg SJ. Sexual potency in aging males: 1. Frequency of coitus among clinic patients. J Am Med Assoc. 1959;170(12):1391-3.

Kunelius P, Häkkinen J, Lukkarinen O. Sexual functions in patients with benign prostatic hyperplasia before and after transurethral resection of the prostate. Urological Res. 1998;26(1):7-9.

Stamey TA. Editorial. Monographs in Urol. 1993;12:14-6.

Kaplan SA. Transurethral resection of the prostate-is our gold standard still a precious commodity? J Urol. 2008;180:15-6.

Downloads

Published

2018-03-23

Issue

Section

Original Research Articles