Journal List > Korean J Urol > v.49(10) > 1005203

Yu, Kim, Ham, and Choi: Transurethral Resection of Prostate in Benign Prostatic Hyperplasia Patients with Large Prostate Volume

Abstract

Purpose

We investigated the safety and efficacy of transurethral resection of the prostate (TURP) in benign prostatic hyperplasia (BPH) more than 60cc by single surgeon for the relief of infravesical obstruction.

Materials and Methods

We evaluated 211 patients treated with TURP in BPH with large prostate by single surgeon. Each group was divided by prostate volume (group 1; 60–69.9, group 2; 70–79.9, group 3; 80–89.9, group 4; 90–99.9, group 5; >100cc of prostate volume). Various parameters such as International Prostate Symptom Score (IPSS), maximal flow rate (Qmax.), postvoid residual volume (PVR), prostate volume, adenoma volume, resection time, resection prostate volume, irrigation fluid volume and complications were evaluated and compared.

Results

Age of each group was not significantly different. Prostate volume, adenoma volume, resection time, Resection volume, irrigation volume of each groups were different significantly. But, resection volume/resection time and irrigation volume/resection time were not different significantly. Mean resection volume/resection time was 1.34g/min, and mean irrigation volume/resection time was 315.8ml/min. And intraoperative and postoperative complications of each group were not different. Mean postoperative change of Hb was 2.0±1.1g/dl. Postoperative parameters (IPSS, Qmax, PVR) were improved significantly. Only 2 patients needed transfusion in group 5. No urinary incontinence and TUR syndrome in each group was observed.

Conclusions

TURP by experienced surgeon is a safe and effective treatment in BPH patients with large prostates for relief of infravesical obstruction.

References

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Fig. 1.
Resection volume/resection time (g/min) in each group.
kju-49-906f1.tif
Fig. 2.
Irrigation volume/resection time (100ml/min) in each group.
kju-49-906f2.tif
Table 1.
Preoperative and postoperative characteristics of patients
Group 1 Group 2 Group 3 Group 4 Group 5
Preoperative
Age (years) 72.2±6.8 69.2±6.8 70.4±7.4 70.9±7.8 70.6±8.5
PSA 5.9±3.4 6.6±4.6 8.8±5.4 8.7±4.1 9.6±5.8
IPSS 24.4±3.4 25.2±3.9 26.1±4.2 26.7±4.8 28.6±6.5
Qmax (ml/sec) 4.9±2.4 4.7±2.0 4.5±2.6 4.6±2.7 4.2±2.1
PVR (ml) 227.5±143.2 243.7±132.7 220.7±152.6 263.5±132.9 289.2±126.8
Postoperative        
IPSS 6.3±0.7 5.6±1.2 4.6±1.1 5.4±0.9 4.5±1.1
Qmax (ml/sec) 18.5±3.3 18.2±3.6 19.5±2.9 17.3±3.7 19.6±3.5
PVR (ml) 43.2±15.2 48.3±16.2 62.3±20.2 53.5±33.2 51.4±29.4

PSA: prostate-specific antigen, IPSS: International Prostate Symptom Score, Qmax: maximal flow rate, PVR: postvoid residual

Table 2.
Intraoperative characteristics of patients
Group 1 Group 2 Group 3 Group 4 Group 5
Preoperative        
Prostate volume (cc) 64.5±3.2 74.7±2.7 83.7±2.6 92.7±2.9 125.2±26.8
Adenoma volume (cc) 33.3±6.9 39.4±14.7 46.0±7.7 53.6±14.1 57.9±21.9
Intraopertive        
Resection volume (g) 36.1±6.7 42.6±7.2 47.6±8.1 56.4±9.2 74.5±19.1
Resection time (minutes) 26.5±4.3 31.2±5.1 36.5±6.1 42.3±5.7 55.6±11.3
Resection volume/time (g/min) 1.36±0.25 1.36±0.23 1.30±0.22 1.33±0.22 1.34±0.34
Adenoma volume/Resection vol 0.94±0.25 0.98±0.29 0.97±0.17 0.92±0.25 0.91±0.27
Irrigation volume (100ml) 82.4±13.4 98.6±22.4 117.6±19.6 137.1±25.9 165.7±34.5
Irrigation volume/time (100ml/min) 3.11±0.29 3.18±0.49 3.22±0.32 3.25±0.35 3.03±0.36
Hg decrease (g/dl) 1.7±1.1 1.5±0.6 2.1±0.7 1.9±1.2 3.3±0.6
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