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Article
Affiliation(s)

Kanpur Urology Centre, Kanpur 208012, India

ABSTRACT

Introduction & Objective: TURP (transurethral resection of prostate) is the gold standard of treatment for patients with BPE (benign prostatic enlargement). But TURP is criticized due to its morbidity and mortality. We analyzed our two decade data and found that the morbidity can be reduced by taking simple precautions in the later decade. Methods: A total of 13,786 patients were studied in the past two decades (Jan. 1994-Dec. 2014) operated by single surgeon, grouped in A (Jan. 1994-Dec. 2004) and B (Jan. 2004-Dec. 2014). Patients with concomitant stricture urethra, vesical calculus/tumor and carcinoma prostate were excluded from the study. Patients were operated under good antibiotic cover. The demographic profile, operative findings, weight, biopsy and post op follow up for 6 months & the immediate and immediate six months post operative complications were recorded. All patients in group B had urethral dilatation up to 27 F, restricted resection time of 90 minutes, concomitant bilateral BNI (bladder neck incision) in small glands ( < 30 gms.), catheter care twice a day with betadine lotion and neosporin ointment & long term antibiotic prophylaxis in biopsy proven BPH (Benign prostatic hyperplasia) with chronic prostatitis patients. Results: A total of 6,800 patients were enrolled in Group A and 6,986 in Group B. In the immediate postop period there was significant drop in TUR (Trans urethral resection) syndrome and clot evacuation (p > 0.01) in group B. In the Late complications there is significant drop in the incidence of meatitis, meatal stenosis, stricture urethra & bladder neck stenosis (p > 0.001) in group B. Conclusions: TURP is still the gold standard of treatment for BPE and its morbidity can be reduced by simple measures like restricting resection time to 90 minutes urethral dilatation before insertion of resectoscope, catheter care & concimitent concomitant BNI in glands of < 30 gms.

KEYWORDS

Transurethral, prostate, complications.

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