You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy and New Technology II1 Apr 20102084 HAS MODERN TURP EVOLVED OVER THREE DECADES?: A COMPARATIVE ANALYSIS Stephanie Kroeze, Erik Mayer, Samarth Chopra, Alex Bottle, and Anup Patel Stephanie KroezeStephanie Kroeze Utrecht, Netherlands More articles by this author , Erik MayerErik Mayer London, United Kingdom More articles by this author , Samarth ChopraSamarth Chopra Palmerston North, New Zealand More articles by this author , Alex BottleAlex Bottle London, United Kingdom More articles by this author , and Anup PatelAnup Patel London, United Kingdom More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.2145AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES TURP remains the gold standard treatment for symptomatic benign prostatic hyperplasia (BPH). The shift to initial medical treatment BPH raises the question whether outcomes of contemporary TURP have significantly changed over the last 20 years. The aim of this study was to determine whether prostates treated by TURP have changed with regard to size, operative parameters, and outcomes, compared to successive pre-ceding decades. METHODS A systematic review of the literature was performed limited by English language and 1997-2007 to extract abstracts of prospective RCTs of TURP versus another technology from treatment of bladder outflow obstruction. Papers using the same cohort of patients were considered as one study. Monopolar TURP cohort data of each study were pooled for analysis, weighting studies according to patient numbers. Where possible, pooled post-operative outcome results were compared with large cohort studies previously reported by Borboroglu et al. and Mebust et al. 20 years ago. RESULTS The final analysis included a total of 3613 patients from 70 studies. Mean patient age (66.9 years) was unchanged while weighted mean pre-operative prostate volume of 47.5g was greater than that previously reported by Borboroglu and Mebust. The weighted mean resected prostate tissue weight of 26.2g (55% total gland volume) with a weighted resection time of 38.5 minutes gave a resection efficiency of 0.68g/min. A statistically significantly reduced transfusion rate and greater urinary tract infection rate was seen as compared to Mebust's study. Catheterisation duration was shorter (weighted mean 2.6 days) along with a reduced rate of post-operative urinary retention (weighted mean 4.9%), despite a trend towards higher pre-operative residual volumes (mean 122mls). CONCLUSIONS This study provided evidence of larger prostate volume in contemporary RCTs of electrosurgical TURP, compared to past eras. This change may reflect the effect modern medical management of LUTS as a prelude to surgery. Despite larger prostate size, surgical efficiency was improved, resected weight was greater, and major morbidity with regard to transfusion rate and duration of catheterisation were reduced. Outcomes were adversely impacted by higher pre-operative residual urine volumes coupled with a possibly higher rate of post surgical re-catheterisation, and may suggest worsening detrusor function on prolonged medical therapy. © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e810 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Stephanie Kroeze Utrecht, Netherlands More articles by this author Erik Mayer London, United Kingdom More articles by this author Samarth Chopra Palmerston North, New Zealand More articles by this author Alex Bottle London, United Kingdom More articles by this author Anup Patel London, United Kingdom More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...