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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
Article
Transurethral Resection of Prostate—Lessons Learnt
Author(s)
Mishra Vinod Kumar and Mishra Divyanti
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DOI:10.17265/2328-7136/2017.06.005
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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