Conventional TURP Research Articles

A comparative study between HoLEP and bipolar TURP in the treatment of benign prostatic hyperplasia

<b>Introduction: </b>Benign Prostatic Hyperplasia (BPH) is one of the most frequent diseases in men. The laser treatment for BPH has challenged TURP due to advances in laser technology, a better understanding of tissue-laser interactions and rowing clinical experience.<br /> <b>Objective: </b>To evaluate the safety and efficacy of HoLEP, comparing it to Bipolar TURP.<br /> <b>Material and methods: </b>This was a prospective study to evaluate the outcomes in BPH patients undergoing surgery by HOLEP and Bipolar TURP done between January 2018 to December 2019. A total of 80 Patients were enrolled, 40 undergoing HoLEP and the other 40 Bipolar TURP for BPH. The procedures were performed by a single surgeon. All patients with symptomatic BPH and who were candidates for surgical treatment were included. Patients with previous prostate surgery, urethral surgery, history of prostate cancer or neurogenic bladder were excluded.<br /> <b>Results: </b>Baseline parameters were almost similar between both the groups in terms of age, IPSS, QOL, Q max, PVR, and gland size. Operative time and resected gland weight were more in HoLEP arm (p<0.001). Catheter time and Hospital stay were significantly low in the HoLEP group (p<0.0001). Hemoglobin drop was not significant (p=0.148). IPSS at three months was similar in both groups (p=0.608). Qmax improved significantly in both groups, with 18.87 ml/s in TURP and 17.87 ml/s in HoLEP with a p-value of 0.261. PVR and QOL were similar between the two groups (P=0.914 and P=0.781).<br /> <b>Conclusion: </b>Both Bipolar TURP and HoLEP were effective in relieving BOO. HoLEP has equal efficacy compared to conventional bipolar TURP, with decreased hospital stay and catheter indwelling time. The learning curve of HoLEP is steep; however, it can be overcome gradually.

Preservation of antegrade ejaculation after surgical relief of benign prostatic obstruction is a valid endpoint

To review the current data on retrograde ejaculation (RE) and ejaculatory dysfunction (EjD) after endoscopic and minimally invasive surgical treatment of benign prostatic obstruction (BPO) and, their perceived impact in the quality of life (QoL) and sexual life of patients and their partners. Narrative review of systematic reviews (SR) assessing comparative rates of RE, EjD or erectile dysfunction (EF) was carried out. Relevant articles on the prevalence of RE, EjD or EF and on their impact in the QoL or sexual life of patients and partners were manually selected based on relevance. Twelve SRs reporting on comparisons of different endoscopic/minimally invasive treatments of BPO were found. Data on outcomes varied widely. Overall, after conventional TURP or laser techniques 42-75% of patients present RE. Prostatic incision and ablative procedures present lowest rates of de novo RE or EjD whereas laser adenomectomy and ejaculation preservation procedures preserve antegrade ejaculation in 46-68% of patients. EjDs is associated to LUTS and present in 10% of sexualy active men before intervention. It modulates the QoL and sexual life of the couple. In spite of the scarce literature assessing patient's and partner's perception of postoperative EjD, it strongly suggests that both parties value the maintenance of the ejaculatory function. Ejaculation-preserving techniques and minimally invasive techniques successfully prevent BPO treatment-induced RE or EjD in 70-100% of the cases. While this is appealing to patients and spouses, technique selection and treatment durability are issues to be discussed with the couple.

PT189 - Inferior tissue ablation after 120W greenlight laser vaporization does not result into inferior clinical outcome compared to conventional TURP: Update of a prospective 3D ultrasound volumetry study after 5 years

PT189 - Inferior tissue ablation after 120W greenlight laser vaporization does not result into inferior clinical outcome compared to conventional TURP: Update of a prospective 3D ultrasound volumetry study after 5 years

MP62-03 EJACULATION-PRESERVING GREENLIGHT PHOTOVAPORIZATION: SHORT- AND LONG TERM RESULTS

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology I1 Apr 2018MP62-03 EJACULATION-PRESERVING GREENLIGHT PHOTOVAPORIZATION: SHORT- AND LONG TERM RESULTS Steeve DOIZI and Bertrand LUKACS Steeve DOIZISteeve DOIZI More articles by this author and Bertrand LUKACSBertrand LUKACS More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.2004AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Loss of antegrade ejaculation is a risk with benign prostatic obstruction relief surgery whatever the technique used. The aim of this study was to determine the short- and long-term preservation of antegrade ejaculation and functional results with ejaculation-preserving Greenlight photovaporization. METHODS All consecutive patients with LUTS and sexually active scheduled for BPO relief surgery in a tertiary reference center were included in this prospective evaluation between January 2010 and December 2013. All patients were offered a surgical treatment with preservation of the ejaculatory function and were informed of the risk of failure and early recurrence of LUTS with the need of medication or surgery. Endpoints were change in objective (uroflowmetry, postvoid residual [PVR]), and subjective (International Prostate Symptoms Score [IPSS], Life Quality Index [LQI]; Danish prostate symptom score sex questionnaire (DAN-PSSsex). Evaluation was performed at 1-3, 3-6, 6-12, 12-24, 24-36, >36 months. RESULTS Overall, 65 patients with mean age of 62.15 years were included. Antegrade ejaculation was preserved in 59 of 65 (90.7%) patients at 1-3 months (Table 1). This rate remained constant until 24-36 months. Significant improvements in maximum flow rate, micturition volume, and PVR were observed at 3 months. Micturition symptoms, as measured by IPSS and LQI, were also significantly reduced. Improvements were maintained up to 36 months (Table 2). No serious adverse events were reported. Seven (10.8%) patients received a second ejaculation-preserving Greenlight photovaporization due to recurrence in symptoms. CONCLUSIONS Antegrade ejaculation was preserved with the use of ejaculation-preserving Greenlight photovaporization with excellent outcome. Observed symptomatic and functional outcomes were comparable with conventional TURP. The results from this study underline the necessity of reviewing the old concept of ejaculation physiology. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e832-e833 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Steeve DOIZI More articles by this author Bertrand LUKACS More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

1080 Prostatic artery embolization vs conventional TUR-P in the treatment of benign prostatic hyperplasia: First results of a prospective, randomized non-inferiority trial

1080 Prostatic artery embolization vs conventional TUR-P in the treatment of benign prostatic hyperplasia: First results of a prospective, randomized non-inferiority trial

Management of prostate enlargement with acute urinary retention: Diode laser vaporization in combination with bipolar transurethral resection of the prostate

ObjectiveTransurethral resection of prostate (TURP) has long been the gold standard for the management of benign prostate enlargement (BPE). Over the years, laser techniques have been developed as major alternative treatment for BPE. Retrospectively, we compared the preoperative status and surgical outcomes of conventional TURP with those of high-intensity diode laser vaporization in combination with bipolar TURP (DV + bTURP) in patients with BPE who are suffering from refractory acute urinary retention. Materials and methodsThis is a retrospective chart review study. A total of 60 patients with BPE who were suffering from refractory acute urinary retention were enrolled between July 2011 and July 2013. Thirty-four patients were included in the TURP group and 26 in the DV + bTURP group. Perioperative parameters, including operation time, hemoglobin decrease, length of hospital stay, and time for catheter removal, were all recorded. Patients were followed postoperatively with peak flow rate measurement, international prostate symptom scores, and postvoid residual volume, and all adverse events were also recorded. ResultsDV + bTURP was superior to TURP in terms of hospital stay (3.1 d vs. 4.2 d), catheter removal time (1.3 d vs. 3.2 d), hemoglobin reduction (0.8 g/dL vs. 2.5 g/dL), and fewer adverse events. However, it was inferior to TURP in terms of operation time (93.2 min vs. 68.5 min). Complications are also comparable. No significant differences were observed in peak flow rates, international prostate symptom score, and postvoid residual volume between the two procedures. ConclusionDV + bTURP is comparable with monopolar TURP for relieving acute urinary retention in men with BPE in terms of complications and functional outcomes. The combined technique can provide better intraoperative hemostasis and shorter catheterization time, with no significant postoperative irritative symptoms.

MP3-12 LONG-TERM EVALUATION OF TRANSURETHRAL INCISION OF THE PROSTATE FOR TREATMENT OF BENIGN PROSTATE HYPERPLASIA: ANALYSIS OF 75 CASES WITH A MEAN 8-YEAR FOLLOW-UP PERIOD.

were also contacted by telephone or mailed surveys for documentation of long-term results. RESULTS: The mean age was 65.5 years (range 45 to 91) and mean procedure time was 56.6 minutes (range 25 to 173), respectively. The mean specimen weight was 68.2 g (range 45 to 226 grams), 9 (4.10%) patients were diagnosed with adeno carcinoma of prostate. The mean hospital stay was 3.1 days. The rate of tissue clearance was 2.3 gram/min. Three patients required postoperative transfusions (1.36 %). No deaths, major complications (myocardial infarction or pulmonary embolism), or transurethral resection syndrome episodes occurred. Intraoperative complications consisted of three capsular perforations (1.5.%). Of 219 patients, 164 (74.88%) provided follow-up data for delayed complications, including three clot retention episodes (1.36%), five urethral strictures (3.65%) and 12 patients requiring recatheterization (5.47%). Mean IPSS was reduced from 22 to mean IPSS to12, mean Qmax 7 was improved to mean Qmax 15ml/sec. Mean PVR was reduced from 138 (range 0e500ml) ml to mean PVR 60 (range 0125ml) at 12 months. The cost of TUERP was similar to TURP approximately US $ 500.00 compared to US$2500 for HoLEP. CONCLUSIONS: TUERP using Unipolar Resectoscope can be performed with minimal complication risks and blood loss The procedure can be completed with out any extra cost as it is truly a modification of conventional gold standard TURP.

MP3-11 RESULTS OF TRANS URETHRAL ENUCLEATION AND RESECTION OF PROSTATE (TUERP) USING UNIPOLAR RESECTOSCOPE: A COST EFFECTIVE NEW TECHNIQUE!

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology I1 Apr 2015MP3-11 RESULTS OF TRANS URETHRAL ENUCLEATION AND RESECTION OF PROSTATE (TUERP) USING UNIPOLAR RESECTOSCOPE: A COST EFFECTIVE NEW TECHNIQUE! Muhammad Salam, Jahangir Kabir, Ehetesham Haque, Faisal Islam, Ghazi Shahinul Islam, and Ibrahim Kaisar Muhammad SalamMuhammad Salam More articles by this author , Jahangir KabirJahangir Kabir More articles by this author , Ehetesham HaqueEhetesham Haque More articles by this author , Faisal IslamFaisal Islam More articles by this author , Ghazi Shahinul IslamGhazi Shahinul Islam More articles by this author , and Ibrahim KaisarIbrahim Kaisar More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.114AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To review the results of 219 TUERP procedures performed with Unipolar Resectoscope for the large prostate greater than 60 gram. TUERP is a minimally invasive surgical treatment for benign prostatic hyperplasia with 60 gram and above. The procedure is all the way similar to Holmium Yag Laser (HoLEP) enucleation of prostate with out any extra cost. METHODS A total of 219 patients with benign prostatic hyperplasia with bladder outflow obstruction and prostate volume >60 gm were prospectively randomized and enrolled in this study. The study was conducted from Jan 1, 2010 to December 31, 2012. All patients underwent TUERP with Unipolar Resectoscope. Demographic, intraoperative, and immediate postoperative data were recorded. Patients were also contacted by telephone or mailed surveys for documentation of long-term results. RESULTS The mean age was 65.5 years (range 45 to 91) and mean procedure time was 56.6 minutes (range 25 to 173), respectively. The mean specimen weight was 68.2 g (range 45 to 226 grams), 9 (4.10%) patients were diagnosed with adeno carcinoma of prostate. The mean hospital stay was 3.1 days. The rate of tissue clearance was 2.3 gram/min. Three patients required postoperative transfusions (1.36 %). No deaths, major complications (myocardial infarction or pulmonary embolism), or transurethral resection syndrome episodes occurred. Intraoperative complications consisted of three capsular perforations (1.5.%). Of 219 patients, 164 (74.88%) provided follow-up data for delayed complications, including three clot retention episodes (1.36%), five urethral strictures (3.65%) and 12 patients requiring re-catheterization (5.47%). Mean IPSS was reduced from 22 to mean IPSS to12, mean Qmax 7 was improved to mean Qmax 15ml/sec. Mean PVR was reduced from 138 (range 0–500ml) ml to mean PVR 60 (range 0- 125ml) at 12 months. The cost of TUERP was similar to TURP approximately US $ 500.00 compared to US$2500 for HoLEP. CONCLUSIONS TUERP using Unipolar Resectoscope can be performed with minimal complication risks and blood loss The procedure can be completed with out any extra cost as it is truly a modification of conventional gold standard TURP. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e22-e23 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Muhammad Salam More articles by this author Jahangir Kabir More articles by this author Ehetesham Haque More articles by this author Faisal Islam More articles by this author Ghazi Shahinul Islam More articles by this author Ibrahim Kaisar More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Prostatic artery embolization versus conventional TUR-P in the treatment of benign prostatic hyperplasia: protocol for a prospective randomized non-inferiority trial.

BackgroundBenign prostatic hyperplasia (BPH) is a prevalent entity in elderly men and transurethral resection of the prostate (TURP) still represents the gold standard of surgical treatment despite its considerable perioperative morbidity. Recently, prostatic artery embolization (PAE) was described as a novel effective and less invasive treatment alternative. Despite promising first results, PAE still has to be considered experimental due to a lack of good quality studies. Prospective randomized controlled trials comparing PAE with TUR-P are highly warranted.Methods/designThis is a single-centre, prospective, randomized, non-inferiority trial comparing treatment effects and adverse events of PAE and TURP in a tertiary referral centre. One hundred patients who are electable for both treatment options are randomized to either PAE or TURP. Changes of the International Prostate Symptom Score (IPSS) after 3 months are defined as primary endpoint. Changes in bladder diaries, laboratory analyses, urodynamic investigations and standardised questionnaires are assessed as secondary outcome measures. In addition contrast-enhanced magnetic resonance imaging of the pelvis before and after the interventions will provide crucial information regarding morphological changes and vascularisation of the prostate. Adverse events will be assessed on every follow-up visit in both treatment arms according to the National Cancer Institute Common Terminology Criteria for Adverse events and the Clavien classification.DiscussionThe aim of this study is to assess whether PAE represents a valid treatment alternative to TURP in patients suffering from BPH in terms of efficacy and safety.Trial registrationClinicalTrials.gov NCT02054013.

Day care monopolar transurethral resection of prostate: Is it feasible?

Introduction:Benign prostatic hyperplasia is a common disease accounting for 30% of our OPD cases and about 25% of our surgery cases. Various treatment options are now available for more efficient care and early return to work. We wanted to determine the safety and feasibility of day care monopolar transurethral resection of prostate (m-TURP), by admitting the patients on the day of surgery and discharging the patient without catheter on the same day. We also compared the morbidity associated with conventional TURP where in the catheter is removed after 24-48 h of surgery and day care TURP where in the catheter is removed on the day of surgery.Materials and Methods:A total of 120 patients who fulfilled the criteria were included in the study which was conducted between November 2008 and December 2010. A total of 60 patients were assigned for day care and 60 for conventional monopolar TURP. There was no significant difference in age, prostatic volume or IPSS score. Day care patients were admitted on day of surgery and discharged the same day after the removal of catheter.Results:Both the groups were comparable in outcome. Stricture rate was less with day care TURP. Mean catheterization time was similar to laser TURP.Conclusion:Monopolar TURP is still the gold standard of care for BPH. If cases are selected properly and surgery performed diligently it remains the option of choice for small and medium sized glands and patients can be back to routine work early.

Ejaculation-Preserving Transurethral Resection of Prostate and Bladder Neck: Short- and Long-Term Results of a New Innovative Resection Technique

Loss of antegrade ejaculation is a risk with conventional resection of the prostate (transurethral resection of the prostate [TURP]). The aim of this study was to determine the short- and long-term preservation of antegrade ejaculation and functional results with the novel ejaculation-preserving TURP (epTURP). Prospective evaluation of 89 consecutive patients with bladder outlet obstructions aged 27 to 78 years, enrolled from June 2001 to January 2005. Endpoints were change in objective (uroflowmetry, postvoid residual [PVR]), and subjective (International Prostate Symptoms Score [IPSS], Life Quality Index [LQI]; International Index of Erectile Function-5 [IIEF-5+] with two additional questions) measures of function. All patients received follow-up examinations at 3 and ≥60 months. Overall, 87 and 63 patients were evaluated after 3 and 60 months, respectively. Antegrade ejaculation was preserved in 79 of 87 (90.8%) patients at 3 months. Significant improvements in maximum flow rate (+14.3 mL/s), micturition volume (+71.6 mL), and PVR (-59 mL; p≤0.002 for all) were observed at 3 months. Micturition symptoms, as measured by IPSS and LQI, were also significantly reduced (mean change of 18.3 and 2.9, respectively; p<0.001). Improvements were maintained at 60 months. No serious adverse events were reported. Eight (12.7%) patients received a second epTURP due to the development of bladder neck scar tissue during long-term follow-up. Antegrade ejaculation was preserved with the use of epTURP with excellent outcome. Observed symptomatic and functional outcomes were comparable with conventional TURP. The results from this study underline the necessity of reviewing the old concept of ejaculation physiology.

Transurethral Resection of Prostate Abscess: Is It Different from Conventional Transurethral Resection for Benign Prostatic Hyperplasia?

Purpose. To present our experience of prostate abscess management by modified transurethral resection (TUR) technique. Methods. Seventeen men with prostate abscess undergoing TUR between 2003 and 2011 were retrospectively analyzed. Details of demography, surgical procedures, complications, and followup were noted. Results. With a mean age of 61.53 ± 8.58 years, all patients had multifocal abscess cavities. Initially, 6 men underwent classical TUR similar to the technique used for benign prostatic enlargement (group 1). Next, 11 men underwent modified TUR (group 2) in which bladder neck and anterior zone were not resected. The abscess cavities resolved completely, and no patient required a second intervention. One patient in group 1 and three in group 2 had postoperative fever requiring parenteral antibiotics (P = 0.916). Three patients in group 1 had transient urinary incontinence, whereas none of the patients in group 2 had this complication (P = 0.055). Four and five men in group 1 and 2 reported retrograde ejaculation, respectively (P = 0.740). Conclusion. The modified technique of prostate resection edges over conventional TURP in the form of reduced morbidity but maintains its high success rate for complete abscess drainage. It alleviates the need for secondary procedures, having an apparent advantage over limited drainage techniques. Use of this technique is emphasized in cases associated with BPH and lack of proper preoperative imaging.

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We genuinely appreciate the comment on our report about the 2-year outcome of high-risk patients with benign prostatic hyperplasia (BPH) treated with conventional transurethral prostate resection (TURP) vs plasmakinetic prostate resection (PKRP). In recent years, several new techniques (PKRP, holmium laser, etc) have exhibited potential advantages over conventional TURP for treating patients with BPH. We found PKRP to be a safe and effective procedure for treating aged, high-risk patients with BPH.

2179 AIM OF STUDY WAS TO COMPARE PLASMA KINETIC (PK) TRANSURETHRAL RESECTION OF PROSTATE

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy and New Technology III1 Apr 20122179 AIM OF STUDY WAS TO COMPARE PLASMA KINETIC (PK) TRANSURETHRAL RESECTION OF PROSTATE Suresh Patankar Suresh PatankarSuresh Patankar Pune, India More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2352AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Aim of study was to compare bipolar Plasma Kinetic with standard monopolar TURP in terms of catheter time, hospital stay, operating time, blood loss, complications, urinary flow rates and symptom relief, quality of life and International Index of Erectile Function.(IIEF-5) , in large number of patients with 5 years follow up. METHODS A total of 512 patients were randomized to either TURP or PK resection of prostate between January 2004 to December 2005 . All of them were evaluated by detail medical history, physical examination , blood analysis, PSA, urinanalysis and culture, AUA Symptom Score, 3D-TRUS measurement of prostate volume , Omax, IIEF-5 and Quality of Life score. TURP was carried out using a 26 F resectoscope and a single wire loop for resection . Glycine was used as irrigation fluid. For the PK Superpulse system, the dedicated resectoscope was used, and normal saline was used as the irrigation fluid. RESULTS Both groups were comparable in all preoperative parameters. 501 patients had completed 5 years follow-up: 255 (of 261) in the PK group and 246(of 251)in the conventional TURP group. The blood loss observed in PK Superpulse arm (178.62±48.47mL) was significantly less than after conventional TURP (351.56±91.52) (P<0.01). The catheter time in patients operated on PK superpulse was 25.56±7.89 hours, less then that in the conventional TURP arm (40.37±10.48 hours) (P< 0.001). The operative time was less in PK group (74.74±12.34 vs 77±13.80 min, p=0.02). Both procedures resulted in statistically significant improvements in AUA symptom score, Qmax , Quality of life at each postoperative assessment compared with baseline values. All parameters did not differ significantly between the groups at any time. The Hematuria, Clot retension ,Blood transfusion and clinical TUR syndrome, Hyponatremia were statistically less in PK group while no statically difference noted in Capsular perforation ,Urinary tract infection , Urethral stricture and Bladder neck contracture. CONCLUSIONS PK is safe and highly effective technique for relief of BOO which is associated with low rate of side effects.The clinical efficacy of PK is durable and compares favorably with TURP in the mid –term. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e878-e879 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Suresh Patankar Pune, India More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Palliative transurethral resection in men with castration-resistant prostate cancer (CRPC): Minimally invasive procedure with minimal morbidity?

233 Background: About 20 to 30% of men with CRPC with a prostate in situ will develop subvesical obstruction due to locally progressing prostate cancer with time. Treatment options include palliative TURP, urinary diversion by transurethral or suprapubic catheters. There are only few reports critically evaluating the outcome of palliative TURP and the development of associated symptoms of locally progressing CRPC. Methods: We retrospectively reviewed all patients who underwent palliative TURP for locally advanced CRPC with regard to the functional and oncological outcome. In addition, we analysed the frequency of complications associated with locally advanced (LA) CRPC. Patient with incidental prostate cancer were excluded from the analysis. Results: Between 2004–2010 a total of 83 patients were identified. The mean age of the patients was 76 (60–91) years. Mean PSA at time of TURP was 78 (1–253) ng/ml. Initial therapy included androgen deprivation monotherapy in 67.8%, radiation therapy in 28.6% and active surveillance in 3.4%.The mean size of the prostate was 40 (15–130) ml, the mean resected prostate weight was 18.6 (2–56) g. The mean Gleason score was 8.3 (6–10). The indication for palliative TURP was subvesical obstruction with a postvoid residual urine &gt; 100ml in 68.8 %, recurrent gross hematuria in 13.2% and acute urinary retention in 18.1%. 19 (2.9%) pts demonstrated uni- or bilateral upper urinary tract obstruction necessitating drainage by endoluminal stenting or percutaneous nephrostomy. The mean catheterization time was 3.4 (2–6) days; postoperative complications developed in 15 (18.1%) pts and included: urinary retention in 2 pts, intravesical blood clots in 3 pts, permanent suprapubic catheter in 3 pts, stress urinary incontinence in 2 pts and re-do TURP in 3 pts. Perioperative mortality was 0% and after a mean follow-up of 3.6 years, 27 (32.5%) pts had died due to prostate cancer. Conclusions: Palliative TURP in men with LA-CRPC is fairly safe, but side effects are higher compared to conventional TURP. Due to a high frequency of involvement, the upper urinary tract has to be screened prior to palliative TURP.

Evolving Transurethral Resection of the Prostate: Enucleation-Resection of the Prostate

Enucleation-transurethral resection of the prostate (e-TURP) is our evolution of the conventional TURP. The aim of this study was to report our experience with e-TURP for the endoscopic management of benign prostatic hyperplasia (BPH). The e-TURP combines the basic steps of classic TURP with the technique of holmium laser enucleation of the prostate (HoLEP) but using only the bipolar resector. The charts of 64 patients who underwent e-TURP for BPH in our department between October 2005 and October 2009 were retrospectively studied. The mean resected tissue weight was 27.21 g, and the mean operative time was 75.7 min. The mean decreases in hemoglobin and serum sodium levels were 1.63 g/dL and 0.55 mEq/L, respectively. Mean catheter duration was 2.53 days, and the mean total hospitalization time was 3.75 days. There was a significant improvement in urinary peak flow rate (Qmax) 2 months postoperatively (P = 0.009718), as well as a significant decrease in the International Prostate Symptom Score during the same period (P < 0.0001). No major complications were observed, and the rates for early and late complications were 10% and 5%, respectively, at 14.75-month mean follow-up. The e-TURP seems to be a safe and effective method for the endoscopic management of BPH. Further investigation with randomized trials is needed on this matter.

Conventional monopolar resection or bipolar resection in saline for the management of large (>60 g) benign prostatic hyperplasia: An evaluation of morbidity

The objective of this study was to compare the efficacy and safety of bipolar transurethral resection in saline (TURIS) and conventional monopolar transurethral resection (TURP) in men with voiding difficulties due to high volume (>60g) benign prostatic hyperplasia. Between May 2005 and January 2009, 66 men with bladder outlet obstruction due to large benign hyperplasia (BPH) (>60 g) underwent transurethral resection, either by Olympus monopolar or Olympus bipolar TURIS technique. Perioperative and outcome data were recorded and compared. There was no significant difference in patient age, prostate size, PSA, uroflow rate, post voiding residual urine, operation time, catheterization time, and hospital stay. In the monopolar TURP group, an important drop in serum sodium was observed (3.12 mmol/L), statistically significantly different (p = 0.012) from the 1.30 mmol/L drop in the bipolar TURIS group. One case of clinical TUR syndrome was observed in the conventional monopolar TURP group. Early and late complications such as clot retention, urinary retention, bladder neck stenosis, and urethral stricture were identical in both groups. The bipolar TURIS device is a valid treatment option for patients with BPH-related voiding disorders due to high volume BPH. Obviating the risk of TUR syndrome, this minimally invasive procedure may be a good surgical option in the urologist's armamentarium.

MP-06.09: Ultrasound Assessment of Treatment Cavity Size after Greenlight Laser Prostatectomy vs. TURP

Greenlight laser prostatectomy is rapidly gaining status as an effective alternative to TURP in the management of Benign Prostatic Hyperplasia. We sought to evaluate the size of treatment cavity produced after this form of therapy in comparison to that apparent after conventional electrocautery TURP.

POD-06.05: BPH: gyrus loop TURP versus conventional TURP: prospective trial - 3 years follow up

This prospective study sets out to compare the use of Gyrus Loop TURP vs the conventional TURP in patients with symptomatic BPH.

POS-02.78: Intra operative tranrectal ultrasonography guide during TURP: Description of the technique

The end point of a conventional TURP is the appearance of the white fibres of the prostatic capsule. Thus, traditionally, an endoluminal view is used to decide the completeness of resection. We describe the use of tranrectal sonography during TURP, to guide the surgeon during resection. We herein describe the technique and the initial assessment of its advantages and limitations.