Available online Oct 7, 2017.
[ Review ] Volume 26, Issue 2, 2017, Pages 173-177
BACKGROUND:Transurethral resection of the prostate (TURP) is the current gold standard for the operative
management of symptomatic Benign prostatic hyperplasia (BPH) and has excellent long term efficacy. Currently
there is a gradual shift towards bipolar TURP and Holmium enucleation of the prostate (HoLEP) due to fear of
complications, particularly transurethral resection (TUR) syndrome associated with monopolar TURP. However,
bipolar generator and high powered holmium laser resectoscpe remain very expensive and make the bipolar
TURP/HoLEP out of reach for majority of our patients.This study seeks to review our experience with monopolar
TURP with a view to appraising its outcomes and complications seen in our patients.
PATIENTS AND METHODS: Records of 42 patients, who underwent monopolar TURP for BPH between October, 2013 and September, 2016 were reviewed retrospectively. The data of patients who had undergone monopolarTURP,following standardized technique,were retrieved and subjected to statistical analysis.
RESULTS: The mean age of the 42 patients was 67.07±9.38 (range 51 – 86).Those in the age range 60-69 years had most of the procedure.The mean prostate volume was 70±23.74 (ml);the mean prostate specific antigen (PSA) was 5.32±5.4ng/ml. All the patients had spinal anaesthesia.The mean intraoperative time was 71.05±19.07 (mins), while the mean hospital stay for the patients was 61.14±27.13 (hrs).The mean volume of 5% dextrose-water used for irrigation at surgery was 30L.Most of the patients,33(78.6%) had their catheters removed at 3-5 postoperative days.Only,9(21.4%) had catheter for more than 5 days.The mean weight of resected prostatic chips was 29±9.2g. Intraoperatively, 1(2.4%) patient had bleeding that needed blood transfusion, 6(14.3%) had capsular perforations while none of our patients hadTUR syndrome. Postoperatively, 3(7.2%) patients had clot retention while 2(4.8%) had UTI and 32(76%) had retrograde ejaculation. All patients except 1(2.4%) had satisfactory voiding at removal of catheter and subsequent follow up visits.
CONCLUSION: Improved antibiotics, perioperative care and instrumentation have greatly improved the morbidity of modern monopolarTURP and make it still useful for our patients.
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Volume 26 | Issue 2
Page Nos. 173-177
Online since Oct 3, 2017