An update on transurethral surgery for benign prostatic obstruction

Jonathan Shunming Teo, Yee Mun Lee, Henry Sun Sien Ho, Jonathan Shunming Teo, Yee Mun Lee, Henry Sun Sien Ho

Abstract

Clinical benign prostatic hyperplasia (BPH) is one of the most common cause of lower urinary tract symptoms and transurethral resection of prostate (TURP) has been the gold standard technique for surgical treatment of benign prostate obstruction (BPO) over the last 2 decades. Although monopolar TURP is considered a safe and effective option for surgical management of BPO, there are some disadvantages, namely bleeding, transurethral resection syndrome, incompleteness of treatment. This review aims to highlight these problems, and describe the advances in technology and techniques that have evolved to minimise such complications. With the advent of lasers and bipolar technology, as well as enucleative techniques to remove the prostatic adenoma/adenomata, the problems of bleeding, transurethral resection syndrome and incomplete treatment are significantly minimised. Monopolar TURP will likely be replaced by such technology and techniques in the near future such that transurethral surgery of the prostate remain a safe and effective option in alleviating the harmful effects of BPO.

Keywords: Benign prostatic obstruction; Bleeding; Prostatectomy; Transurethral resection of prostate.

References

    1. Reich O., Gratzke C., Stief C.G. Techniques and long-term results of surgical procedures for BPH. Eur Urol. 2006;49:970–978.
    1. Reich O., Gratzke, Bachmann A., Seitz M., Schlenker B., Hermanek P. Morbidity, mortality, and early outcome of transurethral resection of the prostate: a prospective multicentre evaluation of 10,654 patients. J Urol. 2008;180:246–249.
    1. Mebust W.K., Holtgrewe H.L., Cockett A.T., Peters P.C., Writing Committee, the American Urological Association Transurethral prostatectomy: immediate and postoperative complications. Cooperative study of 13 participating institutions evaluation 3885 patients. J Urol. 1989;141:243–247.
    1. Rassweiler J., Teber D., Kuntz R., Hofmann R. Complications of transurethral resection of the prostate (TURP)—incidence, management and prevention. Eur Urol. 2006;50:969–980.
    1. Lynch M., Sriprasad S., Subramonian K., Thompson P. Postoperative haemorrhage following transurethral resection of the prostate (TURP) and photoselective vaporisation of the prostate (PVP) Ann R Coll Surg Engl. 2010;92:555–558.
    1. Tan L., Venkatesh S.K., Consigliere D., Heng C.T. Treatment of a patient with post-TURP haemorrhage using bilateral SAPE. Nat Rev Urol. 2009;6:680–685.
    1. Rehman J., Khan S.A., Sukkarieh T., Chughtai B., Waltzer W.C. Extraperitoneal laparoscopic prostatectomy (adenomectomy) for obstructing benign prostatic hyperplasia: transvesical and transcapsular (Millin) techniques. J Endourol. 2005;19:491–496.
    1. Sotelo R., Spaliviero M., Garcia-Segui A., Hasan W., Novoa J., Desai M.M. Laparoscopic retropubic simple prostatectomy. J Urol. 2005;173:757–760.
    1. Lim K.B., Wong M.Y., Foo K.T. Transurethral resection of prostate (TURP) through the decades—a comparison of results over the last thirty years in a single institution in Asia. Ann Acad Med Singap. 2004;33:775–779.
    1. Wendt-Nordahl G., Häcker A., Reich O., Djavan B., Alken P., Michel M.S. The Vista system: a new bipolar resection device for endourological procedures: comparison with conventional resectoscope. Eur Urol. 2004;46:586–590.
    1. Engeler D.S., Schwab C., Neyer M., Grün T., Reissigl A., Schmid H.P. Bipolar versus monopolar TURP: a prospective controlled study at two urology centers. Prostate Cancer Prostatic Dis. 2010;13:285–291.
    1. Mamoulakis C., Ubbink D.T., de la Rosette J.J. Bipolar versus monopolar transurethral resection of the prostate: a systematic review and meta-analysis of randomized controlled trials. Eur Urol. 2009;56:798–809.
    1. Fagerström T., Nyman C.R., Hahn R.G. Bipolar transurethral resection of the prostate causes less bleeding than the monopolar technique: a single-centre randomized trial of 202 patients. BJU Int. 2009;105:1560–1564.
    1. Elmansy H.M., Kotb A., Elhilali M.M. Holmium laser enucleation of the prostate: long-term durability of clinical outcomes and complication rates during 10 years of follow-up. J Urol. 2011;186:1972–1976.
    1. Gilling P.J., Aho T.F., Framptom C.M., King C.J., Fraundorfer M.R. Holmium laser enucleation of the prostate: results at 6 years. Eur Urol. 2008;53:744–749.
    1. Gilling P.J., Kennett K., Das A.K., Thompson D., Fraundorfer M.R. Holmium laser enucleation of the prostate (HoLEP) combined with transurethral tissue morcellation: an update on the early clinical experience. J Endourol. 1998;12:457–459.
    1. Madsen P.O., Madsen R.E. Clinical and experiment evaluation of different irrigating fluids for transurethral surgery. Invest Urol. 1965;3:122–129.
    1. Ekengren J., Zhang W., Hahn R.G. Effects of bladder capacity and height of fluid bag on intravesical pressure during transurethral resection of the prostate. Eur Urol. 1995;27:26–30.
    1. Hagn R.G. Irrigating fluids in endoscopic surgery. Br J Urol. 1997;79:669–680.
    1. Moorthy H.K., Philip S. TURP syndrome – current concepts in the pathophysiology and management. Indian J Urol. 2001;17:97–102.
    1. Ho H.S., Yip S.K., Lim K.B., Fook S., Foo K.T., Cheng C.W. A prospective randomised study comparing monopolar and bipolar transurethral resection of prostate using transurethral resection in saline (TURIS) system. Eur Urol. 2007;52:517–524.
    1. Gilleran J.P., Thaly R.K., Chernoff A.M. Rapid communication: bipolar PlasmaKinetic transurethral resection of the prostate: reliable training vehicle for today's urology residents. J Endourol. 2006;20:683–687.
    1. Wasson J.H., Bubolz T.A., Lu-Yao G.L., Walker-Corkery E., Hammond C.S., Barry M.J. Transurethral resection of the prostate among Medicare beneficiaries: 1984 to 1997. For the patient outcomes research team for prostatic diseases. J Urol. 2000;164:1212–1215.
    1. Madersbacher S., Kackner J., Brossner C., Rohlich M., Stancik I., Willinger M. Reoperation, myocardial infarction and mortality after transurethral and open prostatectomy: a nation-wide, long term analysis of 23,123 cases. Eur Urol. 2005;47:499–504.
    1. Roos N.P., Wennberg J.E., Malenka D.J., Fisher E.S., McPherson K., Andersen T.F. Mortality and reoperation after open and transurethral resection of the prostate for benign prostatic hyperplasia. N Eng J Med. 1989;320:1120–1124.
    1. Liu C., Zheng S., Li H., Xu K. Transurethral enucleation and resection of prostate in patients with benign prostatic hyperplasia by plasma kinetics. J Urol. 2010;184:2440–2445.
    1. Wei Y., Xu N., Chen S.H., Li X.D., Zheng Q.S., Lin Y.Z. Bipolar transurethral enucleation and resection of the prostate versus bipolar resection of the prostate for prostates larger than 60 gr: a retrospective study at a single academic tertiary care center. Int Braz J Urol. 2016;42:747–756.
    1. Zhao Z., Zeng G., Zhong W., Mai Z., Zeng S., Tao X. A prospective, randomised trial comparing plasmakinetic enucleation to standard transurethral resection of the prostate for symptomatic benign prostatic hyperplasia: three-year follow-up results. Eur Urol. 2010;58:752–758.
    1. Xie L., Mao Q., Chen H., Qin J., Zheng X., Lin Y. Transurethral vapor enucleation of the prostate with plasma vaporization button electrode for the treatment of benign prostatic hyperplasia: a feasibility study. J Endourol. 2012;26:1264–1266.
    1. Taher A. Erectile dysfunction after transurethral resection of prostate: incidence and risk factors. World J Urol. 2004;22:457–460.
    1. Choi S.B., Zhao C., Park J.K. The effect of transurethral resection of the prostate on erectile function in patients with benign prostatic hyperplasia. Korean J Urol. 2010;51:557–560.
    1. Pavone C., Abbadessa D., Scaduto G., Caruana G., Scalici Gesolfo C., Fontana D. Sexual dysfunctions after transurethral resection of the prostate (TURP): evidence from a retrospective study of 264 patients. Arch Ital Urol Androl. 2015;87:8–13.
    1. Hogewoning C.R., Meij L.A., Pelger R.C., Putter H., Krouwel E.M., Elzevier H.W. Sling surgery for the treatment of urinary incontinence after transurethral resection of the prostate: new data on the Virtue male sling and an evaluation of literature. Urology. 2017;100:187–192.
    1. Sundaram P., Kuo T.L.C., Cheng C.W.S., Foo K.T. Early outcome of transurethral enucleation and resection of the prostate versus transurethral resection of the prostate. Singap Med J. 2016;57:676–680.

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