Korean J Urol.  2011 Jun;52(6):406-409.

Current Status of Transurethral Prostatectomy: A Korean Multicenter Study

• Jang DG
• Yoo C
• Oh CY
• Kim SJ
• Kim SI
• Kim CI
• Kim HS
• Park JY
• Seong DH
• Song YS
• Yang WJ
• Cho IR
• Cho SY
• Cheon SH
• Im H
• Cho JS

Abstract

PURPOSE
We aimed to verify the current status of transurethral resection of the prostate (TURP) in Korea.
MATERIALS AND METHODS
The medical records of 1,341 men who underwent TURP in 9 Korean medical centers between 2004 and 2008 were reviewed. The patients were divided into two groups according to time periods: 2004-2005 (group 1) and 2006-2008 (group 2). To verify differences in the two patient groups, age, prostate volume, indications for TURP, preoperative International Prostate Symptom Score (IPSS), and resected tissue weight were evaluated.
RESULTS
The mean age of the patients was 71.2 years and the mean IPSS was 22.7. The patients' characteristics were not significantly different between the two groups. The annual cases of TURP increased over the study period. The proportion of lower urinary tract symptoms (LUTS) as an indication for TURP increased up to 58.3% in group 2 compared with 51.6% in group 1 (p=0.019). However, the proportion of patients who presented with acute urinary retention decreased from 35.5% to 30.3% with marginal statistical significance (p=0.051). Other indications such as hematuria, bladder stone, recurrent urinary tract infection, and hydronephrosis were not significantly different between the groups. The mean resected weights of the prostate were similar (17.5 g in group 1 and 18.3 g in group 2, respectively; p>0.05).
CONCLUSIONS
TURP has been steadily performed in patients with benign prostatic hyperplasia and it is expected to remain constant. LUTS was the most common indication for TURP in recent years.

Keyword

Prostatic hyperplasia; Transurethral resection of prostate

MeSH Terms

Hematuria
Humans
Hydronephrosis
Lower Urinary Tract Symptoms
Male
Medical Records
Prostate
Prostatic Hyperplasia
Transurethral Resection of Prostate
Urinary Bladder Calculi
Urinary Retention
Urinary Tract Infections
Weights and Measures

Figure

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  FIG. 1 Annual cases of transurethral resection of prostate in 9 medical centers Linear regression showed No.=40.8 x year-b. (p=0.026, R-square=0.85).

Reference

1. Fitzpatrick JM. Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA, editors. Minimally invasive and endoscopic management of benign prostatic hyperplasia. Campbell-Walsh urology. 2007. 9th ed. Phliladelphia: Saunders;2803–2844.

2. AUA Practice Guideline Committee. AUA guideline on management of benign prostatic hyperplasia (2003). Chapter 1: Diagnosis and treatment recommendations. J Urol. 2003. 170:530–547.

3. Mebust WK, Holtgrewe HL, Cockett AT, Peters PC. Transurethral prostatectomy: immediate and postoperative complication. A cooperative study of 13 participating institutions evaluating 3,885 patients. J Urol. 1989. 141:243–247.

4. Son H, Song SH, Paick JS. Current laser treatments for benign prostatic hyperplasia. Korean J Urol. 2010. 51:737–744.

5. O'Leary MP. Treatment and pharmacologic management of BPH in the context of common comorbidities. Am J Manag Care. 2006. 12:5 Suppl. S129–S140.

6. Madersbacher S, Marberger M. Is transurethral resection of the prostate still justified? BJU Int. 1999. 83:227–237.

7. Blomqvist P, Ekbom A, Carlsson P, Ahlstrand C, Johansson JE. Benign prostatic hyperplasia in Sweden 1987 to 1994: changing patterns of treatment, changing patterns of costs. Urology. 1997. 50:214–219.

8. McConnell JD, Brukewitz R, Walsh P, Andriole G, Lieber M, Holtgrewe HL, et al. Finasteride Long-Term Efficacy and Safety Study Group. The effect of finasteride on the risk of acute urinary retention and the need for surgical treatment among men with benign prostatic hyperplasia. N Engl J Med. 1998. 338:557–563.

9. Jardin A, Bensadoun H, Delauche-Cavallier MC, Attali P. The BPH-ALF Group. Alfuzosin for treatment of benign prostatic hypertrophy. Lancet. 1991. 337:1457–1461.

10. Miller MI, Puchner PJ. Effects of finasteride on hematuria associated with benign prostatic hyperplasia: long-term follow-up. Urology. 1998. 51:237–240.

11. Wilson JR, Urwin GH, Stower MJ. The changing practice of transurethral prostatectomy: a comparison of cases performed in 1990 and 2000. Ann R Coll Surg Engl. 2004. 86:428–431.

12. Borboroglu PG, Kane CJ, Ward JF, Roberts JL, Sands JP. Immediate and postoperative complications of transurethral prostatectomy in the 1990s. J Urol. 1999. 162:1307–1310.

13. Roehrborn CG, Siami P, Barkin J, Damião R, Major-Walker K, Nandy I, et al. The effects of combination therapy with dutasteride and tamsulosin on clinical outcomes in men with symptomatic benign prostatic hyperplasia: 4-year results from the CombAT study. Eur Urol. 2010. 57:123–131.

14. McConnell JD, Roehrborn CG, Bautista OM, Andriole GL Jr, Dixon CM, Kusek JW, et al. The long-term effect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia. N Engl J Med. 2003. 349:2387–2398.

15. Sieber PR, Rommel FM, Huffnagle HW, Breslin JA, Agusta VE, Harpster LE. The treatment of gross hematuria secondary to prostatic bleeding with finasteride. J Urol. 1998. 159:1232–1233.

16. Shin YS, Park JK. Changes in surgical strategy for patients with benign prostatic hyperplasia: 12-year single-center experience. Korean J Urol. 2011. 52:189–193.

17. Horninger W, Unterlechner H, Strasser H, Bartsch G. Transurethral prostatectomy: mortality and morbidity. Prostate. 1996. 28:195–200.

18. Estey EP, Mador DR, McPhee MS. A review of 1486 transurethral resections of the prostate in a teaching hospital. Can J Surg. 1993. 36:37–40.