Staged Transurethral Resection of Prostate for Large Benign Prostatic Hyperplasia: A Comparative Study with Open Prostatectomy

Lee, Tai Hoon; Hong, Sung Joo; Lee, Min Sung

Abstract

PURPOSE: Although open prostatectomy is usually considered when the prostate gland is greater than 50cc, it needs an incision and relatively longer hospital days and has a potential for intraoperative hemorrhage. For these reasons, we performed staged transurethral resection of the prostate (TURP) consecutively instead of open prostatectomy for benign prostatic hyperplasia (BPH) patient with a prostate larger than 50cc.
MATERIALS AND METHODS
Among total 30 BPH patients with a prostate larger than 50cc in volume, 14 patients underwent immediate repeat TURPs (group A) and 16 patients underwent suprapubic prostatectomies (group B). Preoperative international prostate symptom score (IPSS), uroflowmetry, pressure-flow study, operative data, postoperative immobilization period because of hematuria and other complications were reviewed. IPSS and uroflowmetry were followed up to 6 months after operation.
RESULTS
There were no statistically significant differences in age, preoperative IPSS and Qmax between the two groups. At 6 months after the operation mean Qmax and IPSS were improved in both groups significantly, and while Qmax was higher in the group B, there was no significant difference in decreasing IPSS. In the group A, hospital stay and immobilization period were shorter and there was no patient who needed transfusion because of bleeding or suffered from TUR symdrome. In contrast, 9 (75%) patients needed transfusion because of bleeding in the group B.
CONCLUSIONS
Staged TURP is a valuable surgical method with respect to absence of incision, effective symptom improvement, short hospital stay and postoperative immobilization perod and low risk of complications such as bleeding and TUR syndrome in symptomatic BPH patient who has a prostate volume over 50cc.