Transurethral Prostatectomy Research Articles

Transformations in BPH Surgical Practices: A Longitudinal Study of Trends and Predictions.

The workload for BPH surgery is expected to rise with an increase in life expectancy and a growing population. Surgical modalities for BPH have evolved, shifting towards minimally invasive transurethral procedures. This study aims to investigate the trends in BPH surgical procedures across medical centers in Israel. Data from seven academic medical centers in Israel from 2010 to 2022 were analyzed. Procedures included open prostatectomy, transurethral prostatectomy (TURP), laser enucleation of the prostate (HoLEP), and photovaporization of the prostate (PVP). Statistical analyses were employed, including t-tests, ANOVA, and ARIMA models. Over 12 years, 13,478 BPH procedures were performed. TURP was the most common (72%), followed by open surgery (12%), HoLEP (12%), and PVP (3%). Annual procedures increased by approximately 5% each year, with a cumulative surge of 63% cases by 2022. The average patient's age remained stable. TURP and HoLEP showed continual growth, while open surgery declined. HoLEP exhibited a shorter length of hospital stay compared to other modalities. Predictive models suggest open prostatectomy will cease within two years, while TURP and HoLEP will continue to rise. This study highlights a significant increase in BPH surgical procedures over time, with a notable preference for TURP and HoLEP. The findings emphasize the importance of size-independent techniques like HoLEP for optimal healthcare management in the future.

Ejaculatory-sparing transurethral prostatectomy: a meta-analysis of randomized controlled trials.

Benign prostatic hyperplasia (BPH) is a prevalent urologic condition leading to lower urinary tract symptoms (LUTS). Transurethral prostatectomy has been a cornerstone for surgical management of LUTS due to BPH. A growing interest has recently emerged to develop a surgical approach that can decrease the effect on sexual and ejaculatory functions while maintaining its efficacy in treating LUTS. The aim of this meta-analysis is to assess patient-reported outcomes of ejaculatory-sparing transurethral prostatectomy in management of BPH. Cochrane Library, Scopus, PubMed, and Web of Science databases were searched systematically until July 6, 2024. Randomized controlled trials reporting data on ejaculatory-sparing techniques during transurethral prostatectomy were included. The Cochrane risk-of-bias tool for randomized trials was used for quality assessment. The meta-analysis was conducted with Review Manager software. Numerical data were analyzed by standardized mean difference (SMD), while the risk ratio was used for analysis of categorical data. Fixed or random effects models were used according to heterogeneity. Five randomized controlled trials were included with 274 patients. No statistically significant differences were found between groups for International Prostate Symptom Score (SMD, 0.07; 95% CI, -0.45 to 0.59; P= .79), Qmax (SMD, -0.53; 95% CI, -1.11 to 0.06; P= .08), and International Index of Erectile Function (SMD, 0.89; 95% CI, -0.07 to 1.84; P = .07). Ejaculation was better preserved in ejaculatory-sparing techniques (risk ratio, 0.19; 95% CI, 0.12-0.30; P < .00001). Ejaculatory-sparing transurethral prostatectomy techniques are feasible to preserve ejaculation while improving outcomes without compromising functional voiding outcomes.

Robotic bladder diverticulectomy with concurrent management of bladder outlet obstruction: A choice to consider.

Acquired bladder diverticula (BD) are associated with bladder outlet obstruction. The aim of our study is to analyse the improvement in lower urinary tract symptoms (LUTS) in patients who underwent robot-assisted bladder diverticulectomy (RABD) combined with transurethral prostatectomy (TURP). A prospectively single-centre, single surgeon cohort of four patients with posterolateral BD due to bladder outlet obstruction (BOO) undergoing RABD combined with TURP between 2018 and 2023 was analysed. Median age and maximum BD diameter were 73.5 years and 16 cm, respectively. All patients had severe LUTS and elevated postvoid residual (PVR). Preliminary uroflowmetry revealed bladder outlet obstruction with a median of maximum urine flow rate of 8.5 ml/s. The median operative time and blood loss were 212 min and 100 ml, respectively. No intraoperative complications were recorded. The median length of stay was 4 days. The International Prostate Symptom Score (IPSS) and PVR were compared between baseline, 1 month and 6 months after surgery. IPSS significantly decreased from 24 (IQR 24-25) preoperatively compared to the postoperative, at 1 month follow up 7 (IQR 6-8) (p < 0.0001). PVR significantly decreased too from 165 (IQR 150-187) to 35 ml (IQR 25-42) (p < 0.0001). In transitioning from the 1-month follow-up to the 6-month follow-up, no substantial statistical improvement was observed. Concomitant performance of TURP with RABD is feasible and safe. Diverticulectomy in addiction at the endoscopic procedure should be discussed with patients who have obstructive lower urinary tract symptoms as viable alternative to single procedure individually performed.

Erdafitinib-induced bilateral multifocal serous retinal detachments and severe dry eye related unilateral peripheral ulcerative keratitis in a patient with metastatic urothelial carcinoma

Background: A case of bilateral multifocal serous retinal detachments and dry eye complicated with unilateral peripheral ulcerative keratitis (PUK) during erdafitinib therapy is described. Case description: A 76-year-old male underwent a baseline examination two months after initiating 8 mg erdafitinib therapy (April 2023) due to metastatic urothelial carcinoma. Left subfoveal serous retinal detachment was observed initially but the treatment was resumed as he was asymptomatic. In May 2023, bilateral multifocal subretinal fluid pockets were identified, and the patient was still asymptomatic. However, in June 2023 he complained of bilateral redness and a stinging sensation in his right eye. Bilateral severe dry eye and right PUK were diagnosed. He was prescribed dexamethasone eye drops and sodium hyaluronate artificial tears for both eyes. One week later corneal staining decreased, and progression of PUK ceased. Erdafitinib therapy was discontinued in June 2023 due to the planned transurethral prostatectomy. By July 2023, after discontinuation of the drug and administration of the topical treatment, the dry eye improved and the PUK became inactive. There was also resolution of subretinal fluid pockets in the right eye and a reduction of subretinal fluid pockets in the left eye. After the reinitiation of erdafitinib therapy, serous retinal detachments recurred in both eyes in September 2023, but both corneas remained stable with topical low-dose dexamethasone, cyclosporine-A and artificial tear usage. Conclusion: Erdafitinib therapy may lead to concurrent anterior and posterior segment complications. Multidisciplinary monitoring is crucial for patients undergoing erdafitinib therapy to prevent possible visual disturbances.

Perioperative Nursing Considerations for Transurethral Resection Prostatectomy

The present article was an overview of transurethral resection prostatectomy (TURP) and its prevalence, emphasizing the critical role of perioperative nursing in enhancing patient safety and outcomes. Preoperative nursing assessment was explored, covering the importance of patient history and risk assessment, diagnostic tests and evaluations, patient counseling, and informed consent, as well as preoperative optimization and preparation. The intraoperative nursing management section outlines key responsibilities in setting up the operating room, maintaining infection control, preventing specific clinical risk of TURP, managing anesthesia, ensuring surgical team coordination and communication, and adhering to evidence-based guidelines. Postoperative nursing care focused on immediate recovery and monitoring, pain management strategies, urinary catheter care, early ambulation, complication prevention, and patient education. Emerging trends and innovations in perioperative nursing were discussed, including advancements in surgical techniques, integration of new technologies, telemedicine, and the adoption of holistic care approaches. The present article also addressed the challenges facing perioperative nurses, such as workforce shortages and burnout, research gaps in TURP nursing, and the importance of promoting ongoing education and training. By examining these key elements, the present article provided a comprehensive resource for perioperative nurses, healthcare providers, and researchers, aimed to enhance understanding, improved patient care, and stimulated further advancements in the field.

Frequency of Prostatic Adenocarcinoma in Transurethral Resection of Prostatectomy Done for Benign prostatic Enlargement and Correlation with Serum Level of PSA

Background: Around the world, transurethral resection of the prostate, or TURP, is the most often used surgical procedure for treating benign prostatic hyperplasia (BPH). The current study is designed to evaluate the Frequency of prostatic Adenocarcinoma in transurethral resection of prostatectomy and its correlation with serum levels of PSA. Methods: The Retrospective study was conducted in the Histopathology Lab of Dr. Akbar Niazi Teaching Hospital Islamabad which is an PMDC-approved and ISO-9001-certified hospital. The data for this study was obtained by including consecutive cases of transurethral resection prostatectomy received for analysis in the histopathology lab during the study period. The data was retrieved from Histopathology record files. The slides were viewed and the diagnoses were confirmed. The patient’s serum PSA levels were retrieved from pre-operation hospital medical records. The Patients who presented to the histology lab for diagnosis were reassessed using a Questionnaire based on Performa divided into different sections such as socio-demographic data, reasons, History of Diseases, PSA level, Age, and complications. The collected data was analyzed using SPSS Version 21. Results: In 53 patients 11 were of Prostatic Adenocarcinoma, 14 were benign prostatic hyperplasia and 28 were prostatitis. with number and percentage. Prostate Specific Antigen value was different in patients. The highest reported value was 28ng/ml. The mean was 2.68 ng/ml. Most cases were present between the age group of 50-60 years with 32.1% Prostatic adenocarcinoma frequency was higher in the older age group levels above 4ng/ml were seen in prostatitis and BPH. Conversely, there were cases of prostatic adenocarcinoma with less than/ml PSA levels Conclusion: PSA levels were raised, above 4ng/ml in 8 cases while low in 3 cases of Prostatic adenocarcinoma. PSA levels were also raised in a case of prostatitis and two cases of BPH. We conclude that PSA levels although suggestive are not entirely specific for prostatic adenocarcinoma.

Comparison of urinary incontinence following three different prostate apex disconnection techniques in transurethral thulium laser prostatectomy.

This study investigates the incidence of urinary incontinence following transurethral thulium laser prostatectomy with three different prostate apex disconnection techniques: semi-separation, pre-separation, and post-separation. The findings aim to provide references for clinical treatment. A retrospective analysis was conducted on 74 patients treated with transurethral thulium laser prostatectomy for prostatic hyperplasia from April 2022 to March 2023. Complete clinical and follow-up data were available for 52 patients. Clinical and follow-up data were collected for these patients. A comparison was made of urinary incontinence following the three different types of prostate apex disconnection in transurethral thulium laser prostatectomy. In this study, the immediate postoperative urinary incontinence rate for transurethral thulium laser prostatectomy was 9.62% (5/52), the short-term incontinence rate was 11.54% (5/52), and the long-term incontinence rate was 9.62% (5/52). The immediate postoperative incontinence rates for semi-separation, pre-separation, and post- separation were 8.33% (1/12), 8.33% (2/24), and 12.5% (2/16), respectively. The short-term incontinence rates for semi-separation, pre-separation, and post-separation were 8.33% (1/12), 8.33% (2/24), and 18.75% (3/16), respectively. The long-term incontinence rates for semi-separation, pre-separation, and post-separation were 8.33% (1/12), 8.33% (2/24), and 12.5% (2/16), respectively. The incidence of urinary incontinence following transurethral thulium laser prostatectomy was lower with semi-separation and pre-separation compared to post-separation.

Comparison of the efficacy of HoLEP and TURP in the treatment of elderly benign prostatic hyperplasia patients: a retrospective study.

To prove that holmium laser prostatectomy (HoLEP) is safe and effective in the treatment of benign prostatic hyperplasia (BPH), and is superior to transurethral prostatectomy (TURP) for elderly patients. We retrospectively studied 565 HoLEP patients and 76 TURP elderly patients. HoLEP patients were first divided into three groups according to their age(Under 65 years old group, 65-79 years old group and over 80 years old group), and their preoperative, intraoperative, and postoperative characteristics were then compared. Secondly, the same characteristics of HoLEP and TURP patients over 80 years were compared. Chi-square test, one-way ANOVA and Fisher's exact test were used in this study. Firstly, we compared HoLEP patients in different age groups and found that there was statistically significant difference in diabetes, CCVD and bladder stones, among the three groups (P<0.05).Secondlye, we compared HoLEP and TURP treatments in elderly patients (≥80 years old). The patients with HoLEP had a higher share of diabetes, CCVD and anticoagulation (P<0.05). Moreover, compared with TURP patients, HoLEP patients had shorter enucleation duration, more enucleate prostate weight, fewer hemoglobin diminutions, shorter bladder irrigation time, shorter catheter-indwelling period, and shorter hospital period (P<0.05). Although there was no difference in IPSS, Qmax and QOL between the two groups before operation (P>0.05), the difference was statistically significant, 6 months after the operation (P<0.05). HoLEP is safe and effective for BPH patients, and is superior to transurethral TURP for elderly patients.

Intraoperative electroencephalogram features related to frailty in older patients: an exploratory prospective observational study.

Frailty is an independent risk factor for the increased incidence of postoperative delirium (POD). To date, the effect of frailty on intraoperative electroencephalogram (EEG) changes remains unexplored. The present study, an exploratory analysis of a prospective cohort study, aimed to investigate the differences in EEG characteristics between frail and robust patients. This prospective observational study was conducted between December 2020 and November 2021. The preoperative frailty status was assessed using the FRAIL scale. The patients' baseline (before anesthesia) and intraoperative EEG data were collected using a brain function monitor. Finally, 20 robust and 26 frail older patients scheduled for elective spinal surgery or transurethral prostatectomy under propofol-based general anesthesia were included in the final analysis. Baseline and intraoperative EEG spectrogram and power spectra were compared between the frail and robust groups. No differences were observed in baseline EEG between the frail and robust groups. When the intraoperative EEG spectral parameters were compared, the alpha peak frequency (10.56 ± 0.49 vs. 10.14 ± 0.36Hz, P = 0.002) and alpha peak, delta, theta, alpha, and beta powers were lower in the frail group. After adjusting for age, Charlson Comorbidity Index (CCI), and mini-mental state examination (MMSE) score, the FRAIL score was still negatively associated with total, delta, theta, alpha, and beta powers. Frail patients had reduced EEG (0-30Hz) power after the induction of propofol-based general anesthesia. After adjusting for age, CCI, and MMSE score, frail patients still showed evidence of reduced δ, θ, α, and β power.

Comparison of Clinical Therapeutic Efficacy between TUPKP and HoLEP for Patients Aged 70 Years and Older with Benign Prostatic Hyperplasia: Retrospective Study.

The occurrence of prostate hyperplasia has increased remarkedly, especially in elderly patients; However, research on which surgical treatment is effective and safe for benign prostatic hyperplasia (BPH) in elderly people over 70 years old is limited. This study aimed to investigate the clinical efficacy and safety of transurethral plasma kinetic prostatectomy (TUPKP) and holmium laser enucleation of prostate (HoLEP) as a therapy for benign prostatic hyperplasia (BPH) in the elderly. A total of 148 patients with BPH admitted from December 2022 to December 2023 were chosen and divided into HoLEP (n = 74) and TUPKP (n = 74) groups according to the surgical operation. Perioperative related indexes, preoperative and postoperative international prostate symptom scores and life quality scores were compared between the two groups. The postoperative complications were also counted for the two groups. The HoLEP group had lower intraoperative bleeding, mean operative time, catheter indwelling time and hospital stays than the TUPKP group (p < 0.001). Before treatment, no significant difference in prostate symptom scores was found between the two groups (p > 0.05). After treatment, the prostate symptom scores in the HoLEP group were significantly lower than those in the TUPKP group (p < 0.001). However, the maximum urinary flow rate was significantly higher (p < 0.001) and the residual urine volume was significantly lower (p < 0.001) in the HoLEP group than in the TUPKP group after operation. The complication rate in the TUPKP group was 25.66%, which was significantly higher than the 9.46% in the HoLEP group (p < 0.05). The life quality scores of the HoLEP group were higher than those of the TUPKP group (p < 0.001). HoLEP for BPH therapy is effective and safe with low incidence of postoperative complications.

Quality of care perceived by patients during cystoscopy and affecting factors.

It is necessary and important for quality of care to ensure the comfort of patients during the procedure, as well as before and after surgery. According to literature, it is necessary to know what patients experience and how they perceive the care they receive. This study aimed to investigate the quality of care perceived by patients during cystoscopy and the factors affecting it. This descriptive study was conducted in the surgical clinic of a teaching and research hospital, with 105 patients who underwent cystoscopy in 2022. Data collection forms consisting of a Sociodemographic and Disease Characteristics Questionnaire and the Good Perioperative Nursing Care Scale (for Patients) (GPNCS) were used for data collection, with face-to-face interviews on the first day after the procedure. This study was conducted in accordance with the principles of the Declaration of Helsinki. The study included patients with urinary tract stones, transurethral prostatectomy, and transurethral bladder resection. Of the participants, 72.4% were male, and 81.9% were married. The mean age of the patients was 50.09 ± 16.79 years. The mean total score was 143.56 ± 16.62. It was higher in single patients and those who had not previously undergone surgery. It was found that the mean of the environment sub-dimension was the highest at 18.57 ± 2.51 and the mean of the support sub-dimension was the lowest at 16.01 ± 3.44. The results of this study showed that patients undergoing cystoscopy have a good perception of the quality of their peri-operative nursing care.

Clinical use of high dose-rate brachytherapy in treatment of patients with localized prostate cancer and infravesical obstruction

Background. High dose-rate brachytherapy is a new method of interstitial radiation therapy for treatment of localized prostate cancer. The difference from low dose therapy is temporary implantation of radiation sources with targeted high dose-rate irradiation of the affected organ.Aim. To evaluate 3-year effectiveness and safety of high dose-rate brachytherapy in patients with infravesical obstruction. Materials and methods. Between January of 2017 and December of 2019 at the Central Clinical Hospital “RZD-medicine”, 49 patients (mean age 67.8 ± 7.5 years) with verified prostate cancer diagnosis underwent high dose-rate brachytherapy in the regimen of 2 sessions of 15 Gy with 192Ir source. The inclusion criteria were disease stage ≤сТ2с, Gleason score ≤7. Patients were divided into 2 groups: 1st – patients with incidental prostate cancer (n = 21) who previously (more than 6 months ago, mean time 9.4 ± 2.4 months) underwent transurethral prostatectomy; 2nd – patients with verified prostate cancer (mean prostate volume 56 cm3) and obstructive symptoms without previous transurethral prostatectomy (n = 28).Results. In both groups, no intraoperative complications were observed. In 6 (28 %) patients of the 1st group and 2 patients of the 2nd group, grade II genitourinary toxicity in the form of moderate dysuria and nocturia was observed. Acute gastrointestinal toxicity was observed in 3 (14 %) patients of the 1st group, in the 2nd group such complications were absent. In the 2nd group during the postoperative period after the 2nd session, 4 patients (14 %) experienced acute urinary retention requiring cystostomy.Conclusion. High dose-rate brachytherapy is a safe and effective radical treatment method for patients with localized prostate cancer with obstructive symptoms who have contraindications for surgical treatment.

Leiomyosarcoma of Prostate: Case Report and Literature Review

Prostate sarcomas originate from the mesenchymal tissues including smooth muscle, fibromuscular stroma, paraganglia, nerves, and blood vessels. They account for less than 0.1% of all prostate tumors and often present with obstructive symptoms. It is an aggressive malignancy with a high risk of metastasis and a poor prognosis that poses unique diagnostic and treatment challenges. Histopathological examination is essential for definitive diagnosis, and can be performed at an early stage using guided transrectal prostate biopsy. Since prostate specific antigen levels are generally normal, digital rectal examinations are extremely important. We report on a 51-year-old man who was diagnosed with leiomyosarcoma based on the histopathology of his transurethral prostatectomy specimen.

The effect of bladder function on the efficacy of transurethral prostatectomy in patients with benign prostatic hyperplasia: a retrospective, single-center study.

We investigated the impact and predictive value of bladder function in patients with benign prostatic hyperplasia (BPH) on the efficacy of transurethral prostatectomy. Symptomatic, imaging, and urodynamic data of patients who underwent transurethral prostatectomy at West China Hospital of Sichuan University (Chengdu, China) from July 2019 to December 2021 were collected. Follow-up data included the quality of life (QoL), International Prostate Symptom Score (IPSS), and IPSS storage and voiding (IPSS-s and IPSS-v). Moreover, urinary creatinine (Cr), nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), and prostaglandin estradiol (PGE2) were measured in 30 patients with BPH and 30 healthy participants. Perioperative indicators were determined by subgroup analyses and receiver operating characteristic (ROC) curve analysis. Among the 313 patients with BPH included, patients with severe micturition problems had more improvements but higher micturition grades postoperatively than those with moderate symptoms. Similarly, good bladder sensation, compliance, and detrusor contractility (DC) were predictors of low postoperative IPSS and QoL. The urinary concentrations of BDNF/Cr, NGF/Cr, and PGE2/Cr in patients were significantly higher than those in healthy participants (all P < 0.001). After evaluation, only DC was significantly related to both urinary indicators and postoperative recovery of patients. Patients with good DC, as predicted by urinary indicators, had lower IPSS and IPSS-v than those with reduced DC at the 1 st month postoperatively (both P < 0.05). In summary, patients with impaired bladder function had poor recovery. The combined levels of urinary BDNF/Cr, NGF/Cr, and PGE2/Cr in patients with BPH may be valid predictors of preoperative bladder function and postoperative recovery.

Construction of lncRNA- and circRNA-associated ceRNA networks in the prostatic urethra of rats after simulating transurethral laser prostatectomy (TULP)

Non-coding RNA appears to be involved in wound repair. Competing endogenous RNA (ceRNA) appears to be an important post-transcriptional mechanism, it means that long noncoding RNA (lncRNA) or circular RNA (circRNA) acts as a microRNA (miRNA) sponge to further regulate mRNA. However, ceRNA network related to wound repair after prostatectomy has yet been constructed. TULP is the main surgical method of prostatectomy, but there have been no reports of TULP rat models in the past. We simulated TULP on rats, and observed the whole process of wound injury and repair after operation through pathological examination of wound tissue. Next, we discovered 732 differentially expressed lncRNAs (DElncRNAs), 47 differentially expressed circRNAs (DEcircRNAs), 17 differentially expressed miRNAs (DEmiRNAs), and 1892 differentially expressed mRNAs (DEmRNAs) related to wound repair after TULP through full transcriptome microarray and bioinformatics methods, and confirmed the reliability of transcriptome data by quantitative Reverse Transcription PCR (qRT-PCR), and immunohistochemistry. Then, we constructed the lncRNA- and circRNA-associated ceRNA regulatory networks related to wound repair after TULP in rats. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses showed that molecules in these networks were mainly involved in inflammatory infiltration, cell differentiation, and intercellular interactions and involved signal pathways such as the PI3K-Akt signaling pathway. Thus, this study successfully established the TULP model in rats, revealed potentially important biomarkers and ceRNA networks after prostatectomy in rats, and provided theoretical support for the repair of post-prostatectomy wound.

A feasibility study of urinary catheter removal protocol following transurethral prostatectomy procedure in older patients

AbstractWe hypothesized that older patients who underwent a urinary catheter removal protocol would not have an increased risk of postoperative complications. We further hypothesized that the revised protocol would be more suitable for clinical application. This study aimed to develop a urinary catheter removal protocol after Transurethral Resection of the Prostate and to assess the feasibility of the protocol to support catheter removal and promote recovery of self‐voiding function. Delayed catheter removal after Transurethral Resection of the Prostate was associated with urinary tract infection and longer hospital stays. However, no strategy has been described to promote recovery of self‐voiding function after catheter removal after Transurethral Resection of the Prostate. The urinary catheter removal protocol was developed through expert consensus, including strategies for caring for urinary catheters, assessment of urinary catheter removal, and strategies after urinary catheter removal. Moreover, a quasi‐experimental design was adopted in the urology ward of a tertiary care medical centre in southern Taiwan. Patients aged ≥65 years who underwent Transurethral Resection of the Prostate were included. A total of 13 patients (intervention = 5; control = 8) were included in the feasibility evaluation. A urinary catheter removal protocol after Transurethral Resection of the Prostate was developed and the consensus among experts on the urinary catheter removal protocol was 99%. There were no significant differences in terms of bleeding, urine retention, urinary tract infection, or re‐catheterization between the two groups. However, in the intervention group, the pain score decreased significantly on the second day after Transurethral Resection of the Prostate. This revised urinary catheter removal protocol after Transurethral Resection of the Prostate may be suitable for clinical applications. However, small size reduces the statistical power of the findings and further studies are needed to examine the current protocol does not have an increased risk of postoperative complications.

Serum copeptin as a predictor of risk of hyponatremia after transurethral prostatectomy.

Transurethral resection of the prostate gland (TURP) frequently leads to the development of dilutional hyponatremia. Copeptin has been established as a surrogate marker of vasopressin and is measured for clinical assessment of various sodium and water disturbances. This study aims to assess the utility of serum concentration of copeptin and N-terminal prohormone of brain natriuretic peptide (NT-proBNP) for prediction of post-TURP alterations of serum sodium concentration. Forty-three patients with benign prostatic hyperplasia undergoing TURP were enrolled. Serum sodium and copeptin were measured before the procedure, then 12 hours after its completion. NT-proBNP was assessed at baseline. The total amount of fluids and sodium administered intravenously and used to flush the bladder during TURP was calculated in each patient. Receiver operator characteristic (ROC) curve analysis was used to determine value of copeptin and NT-proBNP for prediction of hyponatremia after TURP. In forward stepwise multiple regression analysis of serum copeptin before surgery and the duration of TURP explained the significant portion of the sodium concentration variation 12 hours from the start of the surgery. ROC curve analysis showed that serum copeptin before surgery predicted development of hyponatremia 12 hours after TURP (area under the curve, 0.775; 95% confidence interval, 0.62-0.89; p &lt; 0.001) with a cut-off point of &gt;78.6 pg/mL with 77% sensitivity and 64.7% specificity. Serum NT-proBNP before surgery did not predict hyponatremia 12 hours after TURP. Serum copeptin before TURP surgery, but not NT-proBNP, may be a clinically useful marker of the risk of serum sodium decrease after TURP.

FEASIBILITY OF EARLY CATHETER REMOVAL FOLLOWING TRANSURETHRAL PROSTATECTOMY: A CASE SERIES

Introduction: Benign prostatic hyperplasia (BPH) is a benign growth of the prostate that develops as a strictly age-related phenomenon in nearly all men from about age 40. Transurethral prostatectomy remains the gold standard. Postoperative care for transurethral resection of the prostate (TURP) includes bladder irrigation with prolonged case immobilisation . Traditionally, catheters are removed approximately 4 days after TURP. This study evaluates the feasibility and safety of early (day 1) catheter removal after transurethral resection of the prostate. Materials And Methods: It is a prospective study. A total of 35 patients who underwent Trans-Urethral Resection of Prostate (TURP) for benign prostatic hyperplasia (BPH) who fullled the inclusion criteria. Patients were randomised by simple random sampling technique and were divided into two groups. 18 cases were assigned for early removal group and their catheter was removed on POD-1 of surgery. 17 cases were taken as control (late removal) group, their catheter was removed on the 4-5th day of surgery as conventionally done. Data of both groups were compared and analysed for statistical signicance using Chi square test and Student 't' test. We set up that early junking of urethral catheter redounded in Result: statistically signicant reduction in length of post-operative sanitarium stay which indicate early mobilisation of the case, lower post-operative pain, early discharge and reduced cost burden on the sanitarium. Also, there was reduced prevalence in urinary tract infections in early junking group which may indicate reduced threat of urethral strictures in future

Prostat lazer cerrahileri sonrası erektil ve ejakülatuvar fonksiyonlar

Benign prostatic hyperplasia (BPH) is a common health condition in aging men resulting in lower urinary tract symptoms (LUTS) and poor quality of life. Until recently, transurethral prostatectomy (TUR-P) was considered the gold standard for prostate surgery, but prostate enucleation methods using advanced laser technologies have become a strong competitor to TUR-P and have become widely used. The effects of all surgical procedures performed for prostate on sexual functions have been the subject of many studies. In today’s world where quality of life is emphasized and technological advances are increasing, the search for treatment methods with minimal effect on sexual function in the surgical treatment of BPH has increased. In this review, the effects of laser surgeries in the treatment of BPH on erectile and ejaculatory function will be presented with the current literature. Keywords: benign prostatic hyperplasia, HOLEP, ThuFLEP, erectile function, ejaculatory function

Recovery of Detrusor Function after Transurethral Prostatectomy in Patients with Benign Prostatic Hyperplasia and Underactive Detrusor: A Systematic Review and Meta-analysis

Recovery of Detrusor Function after Transurethral Prostatectomy in Patients with Benign Prostatic Hyperplasia and Underactive Detrusor: A Systematic Review and Meta-analysis