FRII-12 HISTORY OF THE TRANSURETHRAL RESECTION OF THE PROSTATE: THE GOLD STANDARD AND ITS ROLE IN THE 21ST CENTURY

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You have accessJournal of UrologyHistory of Urology Forum II1 Apr 2015FRII-12 HISTORY OF THE TRANSURETHRAL RESECTION OF THE PROSTATE: THE GOLD STANDARD AND ITS ROLE IN THE 21ST CENTURY Marcus Austenfeld and Ajay Nangia Marcus AustenfeldMarcus Austenfeld More articles by this author and Ajay NangiaAjay Nangia More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.503AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES In 1989 Dr. Winston Mebust, the chairman of the department of Urology at the University of Kansas and future president of the AUA, published the most influential case series on transurethral resection of the prostate (TURP). It has now been 25 years since that landmark paper. This inspired us to examine the history of the TURP. METHODS A search through both bibliographic and digital resources. RESULTS Transurethral resection of the prostate begins with Hugh Hampton Young, often labeled the “Father of American Urology.” Previous methods of resecting the prostate through the urethra relied on blind passage of sounds with concealed blades, which sprung open to incise the bladder neck. In 1909 Young used a tubular sheath with an opening at the distal shaft; one could advance a bite of prostate into the outer sheath and then use a sharpened inner sheath to create a “punch” prostatectomy. Later addition of electrical energy to the inner sheath allowed some level of hemostasis. Maximilian Stern invented the modern resectoscope in 1926 when he added an electrified tungsten loop to scoop out prostatic fragments. By 1931 Joseph McCarthy improved the lens to provide a wider field of view and added a gear system to drive the loop across the prostate through an insulating Bakelite sheath; later that decade Reed Nesbit created the “pistol grip” system more commonly found today. In the 1970s and 1980s further improvement of the lens, the addition of fiber optic lighting and closed circuit video completed the development of the modern resectoscope. Mebust and others solidified the monopolar TURP's position as the gold standard of surgical BPH management in the early 1990s, but options available to the contemporary urologist—bipolar cautery, holmium laser, photoselective vaporization, and even pharmacotherapy—may signal the beginning of the end for the traditional electric loop resection of the prostate. CONCLUSIONS Transurethral resection of the prostate using the resectoscope became a safe and effective option for managing benign prostatic hypertrophy in the 20th century. In the 25 years since Dr. Mebust's paper a wider variety of tools for surgically managing prostatic obstruction are available, but as in 1989, monopolar TURP remains an excellent tool in the hands of a skilled endourologist. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e592-e593 Peer Review Report Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Marcus Austenfeld More articles by this author Ajay Nangia More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...