Clinical Observation for Complications of Non-Surgical Treatment of Benign Prostatic Hyperplasia

Pak, In Je; Kim, Soon Chan

Abstract

Non-surgical treatment of benign prostatic hyperplasia (BPH) have been under investigation with interesting in recent years although transurethral resection of the prostate (TURP) seems to be accepted as a standard treatment of BPH. But the significance of post operative mortality and morbidity of TURP still remains as problem will be solved. We observed complications of non-surgical treatment of BPH from November 1989 to November 1994 including intraprostatic stenting (Prostakath , 13 cases), transurethral balloon dilation of prostate (TUDP, 19 cases), transurethral radiofrequency thermotherapy (FURT, 87 cases) and transurethral radiofrequency thermoablasion (TURTA, 23 cases) and the result revealed as below; 1. Over-all complication rate of intraprostatic stenting is 92.3%(12/13) consisting of hematuria (4 cases), acute urinary retention(1), vesical irritation(1), stone formation(1), stent displacement(1), urge incontinence(3), urinary tract infection(1) and severe bleeding(1). 2. Over-all complication rate of TUDP is 47.4%(9/19) consisting of hematuria (5 cases), acute urinary retention(3) and vesical irritation(1). 3. Over-all complication rate of TURT is 19.5%(17/87) consisting of hematuria (5 cases), acute urinary retention(6), weak stream(4) and urgency(2). 4. Over-all complication rate ofTURTA is 65.2%(15/23) consisting of hematuria (4 cases), acute urinary retention(4), epididymitis(1), urge incontinence(3) and painful urination(2). 5. The subjective improvement rate of patient 3 months after treatment in intraprostatic stenting, TUDP, TURT and TURTA were 46%, 42%, 38% and 70%, respectively. 6. More than 30% of uroflow improvement rate 3 months after treatment in intraprostatic stenting, TUDP, TURT and TURTA were 76.9%, 74%, 60.9% and 82.6%, respectively. As we see above, TURT revealed the lowest over-all complication rate compare to others and it means most safest treatment modality among them but if we consider with the subjective improvement rate of patient and the uroflow improvement rate TURTA seems better treatment modality than others even though high complication rate because no serious complication developed. We suggest that TURTA could be a first choice of treatment modality among non-surgical treatment of BPH in case of non-surgical approach is being considered at any reasons.