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PubMedDate not supplied

[Transrectal magnetotherapy of the prostate from Intramag device in prophylaxis of postoperative complications of transurethral resection of prostatic adenoma].

The authors analyse preoperative preparation of 91 patients with benign prostatic hyperplasia (BPH). Two groups of patients received conventional preparation (group 1) and magnetotherapy (group 2) before TUR of the prostate. The examination covered immune system, bacteriological indices of urine and prostatic tissue. Infection of the urinary tract is a main risk factor of complications after TUR. Conventional preoperative preparation fails to correct immunity, to change bacterial urine flora, to improve hemodynamics in the prostate. Transrectal magnetotherapy with running magnetic field eliminates deficiency of T- and B-cell immunity, raises functional activity of B-lymphocytes and phagocytic ability of neutrophils, reduces endogenic intoxication, tissue edema, bacterial contamination, number of thrombohemorrhagic complications. This leads to a decrease in the number of postoperative complications.

B-Lymphocytes↗
PubMed1991

Early catheter removal vs. conventional practice in patients undergoing transurethral resection of prostate.

A retrospective analysis of 127 of 146 consecutive patients undergoing transurethral resection of the prostate from February 1985 to January 1988 (3-year period) was performed. The catheter was removed on postoperative day 1 in 66 patients (group I) and on postoperative day 2 in 61 patients (group II). There were no significant differences between the two groups in terms of population age, weight of resected glands, operative time, and management. Both groups I and II had 8 complications following catheter removal. Postoperative hospital stay was reduced by an average of 1.37 days in group I. Total hospital cost was reduced by approximately $466.00. We conclude that catheter removal on postoperative day 1 is safe with no added morbidity while having the advantage of reduced hospital costs.

Aged↗
PubMed1995

[Transurethral resection of prostate cancer: efficacy and morbidity].

OBJECTIVES: The efficacy and morbidity of transurethral resection of the prostate (TURP) were evaluated in patients with urinary retention and prostatic carcinoma. METHODS: From 1990 to 1993, 30 patients with infravesical obstruction secondary to prostate cancer were treated by TURP. The results were considered good when patients were able to void and were completely continent following the procedure, whereas poor results were defined as incontinence or no relief of urethral obstruction 21 days following catheter removal. RESULTS: Patient mean age was 72 years and the average weight of resected tissue ranged from 8 to 105 gms (mean 19.5 gms). The median postoperative follow-up period was 20.5 months (range 6-36 months). During this time, there were no deaths and 72.5% of the patients showed normal post-TURP micturition. Eight patients (27.5%) developed the following complications: 3 were incontinent, 6 had persistent obstruction and 1 patient had both complications. Presurgical hormone therapy, high-grade tumors and patient age under 70 years appear to be statistically related to poor outcome following TURP. CONCLUSIONS: TURP is an effective treatment with a relatively low morbidity and offers a viable option for patients with symptomatic urethral obstruction due to prostate cancer.

Aged↗
PubMed2006

Combined transurethral resection of prostate and inguinal mesh hernioplasty.

We aimed to evaluate the difference among early post-operative morbidities of transurethral resection of prostate (TURP), inguinal herniorrhaphy and their combination in this study. Between 1998 and 2004, 44 patients undergoing combined inguinal herniorrhaphy and TURP (Group I) were compared with 50 consecutive cases of TURP alone (Group II) and 50 consecutive cases of inguinal herniorrhaphy alone (Group III). There were no differences in the mean age and mean prostatic volume between Group I and II. The mean operation time and length of hospital stay were 126.1 +/- 20.9 min, 3.0 +/- 0.7 days for Group I, 61.4 +/- 15.6 min and 2.9 +/- 0.69 days for Group II and 55.0 +/- 15.6 min and 1.2 +/- 0.4 days for Group III, respectively. The mean operation time of Group I was found as longer than Group II and III. There were no significant differences among all groups regarding post-operative complications. No mesh infection was detected. Combined TURP and inguinal herniorrhaphy is a practical, safe and effective procedure.

Hernia, Inguinal↗
PubMed1996

The Oxford Laser Prostate Trial: a double-blind randomized controlled trial of contact vaporization of the prostate against transurethral resection; preliminary results.

OBJECTIVE: To compare the results of contact laser vaporization and transurethral resection of the prostate (TURP) in a double-blind randomized controlled clinical trial. PATIENTS AND METHODS: The study comprised 148 patients with clinical benign prostatic hypertrophy (BPH) who were recruited and allocated randomly to undergo either TURP (72 patients) or laser ablation of the prostate (76 patients). The outcome was assessed using the American Urological Association (AUA -7) symptom score after 1 and 3 months as the primary measure and by urinary flow rates, haematological factors and the duration of hospital stay and length of catheterization. RESULTS: With 90% statistical power, the results at 3 months showed no clinical or statistical difference between the treatments in change in AUA symptom score. A lower blood loss, hospital stay and duration of catheterization significantly favoured the laser treatment, although the failure rate of trial without catheter and the rate of re-operation were higher after laser treatment. CONCLUSIONS: These early data are encouraging for this technique, although the outcome after one year requires evaluation before advocating the widespread uptake of this method.

Aged↗
PubMed2006

Prognostic value of DNA ploidy, bcl-2 and p53 in localized prostate adenocarcinoma incidentally discovered at transurethral prostatectomy.

PURPOSE: Discovery of prostatic adenocarcinoma limited to transurethral resection material generates a treatment dilemma. We investigated the usefulness of parameters shown to be associated with prognosis in prostate cancer (p53 and bcl-2 immuno-expression, DNA cell cycle analysis and Gleason score) to stratify these incidentally identified tumors to guide clinical decision making. MATERIALS AND METHODS: Paraffin embedded tissues from transurethral prostate resection specimens containing T1a prostate adenocarcinoma from 44 patients who underwent resection between 1980 and 1990 were immunostained for p53 and bcl-2, and subjected to flow cytometry to determine DNA ploidy. Gleason score was determined by 2 pathologists independently. Statistical relationships among these 4 variables, tumor progression and cancer specific survival were analyzed. RESULTS: Six of 44 patients in the study population had cancer progression. Time to clinical progression was 4.5 years (range 7 months to 11 years). Most tumors stained negative for p53 and bcl-2. Only 2 tumors studied were aneuploid and neither of these 2 patients had cancer progression. Only Gleason score was a significant predictor of cancer progression on univariate and multivariate Cox regression analysis (p = 0.045 and 0.046, respectively). No tumor characteristics correlated with time to disease progression, including p53 and bcl-2 immuno-expression, and Gleason score (p = 0.182, 0.563 and 0.346, respectively). Positive immunostaining for p53 and bcl-2 did not occur together in the same tumor in significant fashion (p = 0.334), nor did either significantly occur more with aneuploidy (p = 0.237 and 0.307 respectively). CONCLUSIONS: For T1a prostate cancer incidentally detected on transurethral prostate resection p53 and bcl-2 immuno-expression, and DNA ploidy do not predict survival or disease progression.

Adenocarcinoma↗
PubMed2003

Current indications for transurethral resection of the prostate and associated complications.

Transurethral resection of the prostate (TURP) is the most common surgical procedure for relieving symptoms of benign prostatic hyperplasia. Here, we report our experience of current indications for TURP and their associated outcomes at Kaohsiung Medical University Hospital (KMUH). A total of 111 patients who underwent TURP at KMUH between May 2000 and December 2001 were included in this retrospective review. For each patient, the surgical indication was categorized into acute urinary retention, chronic complications (including renal impairment, recurrent urinary infection, bladder stone/diverticulum, post-void residue, and recurrent hematuria), and symptomatic prostatism. Thirty-five patients (31%) had acute urinary retention, 28 (27%) had chronic complications, and 48 (42%) had symptomatic prostatism. Most patients chose TURP only when medical treatment had failed to relieve symptoms, no matter what category they belonged to. Patients with acute urinary retention and chronic complications had larger prostates (p = 0.002) and more tissue resected (p = 0.05) than those with symptomatic prostatism. Patients with acute urinary retention seemed to be at greater risk of postoperative complications such as recurrent urinary retention and urinary tract infection. We suggest that urodynamic study may be necessary to rule out concomitant bladder dysfunction before surgery and that adequate prophylactic antibiotic treatment be used to decrease the risk of urinary tract infection during or after TURP, especially when pyuria is noted preoperatively in patients with acute urinary retention.

Aged↗
PubMed2003

Nd:YAG laser ablation plus transurethral resection for large prostates in high-risk patients.

OBJECTIVES: To evaluate the outcome and morbidity rate of combined visual laser ablation of the prostate and transurethral resection of the prostate (TURP) in high-risk symptomatic patients with large prostates. METHODS: A total of 28 patients evaluated according to the American Society of Anesthesiologists (ASA) classification to have ASA grade 3 or greater and who had a prostate volume of 50 cm3 or greater, and peak urinary flow rate of less than 15 mL/s underwent visual laser ablation of the prostate plus TURP for severe lower urinary tract symptoms due to benign prostatic hyperplasia. The postoperative evaluation included the American Urological Association symptom score index, maximal urinary flow rate measurement, postvoid residual urine volume, and morbidity. RESULTS: The mean baseline prostate volume and duration of surgery was 85 cm3 (range 50 to 120) and 70 minutes (range 55 to 105), respectively. Surgery was performed under local and spinal anesthesia in 18 and 10 patients, respectively. No perioperative bleeding requiring transfusion or TURP syndrome developed. Urethral catheter drainage was continued for an average of 1.7 days. Only 1 patient developed irritative voiding symptoms. The postoperative follow-up period ranged from 6 to 21 months (median 11). Improvement in the evaluation parameters was noted in all cases. CONCLUSIONS: The results of our study show that visual laser ablation of the prostate plus TURP has the advantage of excellent homeostasis and lower morbidity in men with large prostates. When the patient's medical condition precludes TURP, this combination of techniques may be considered an option in such cases for symptomatic relief of obstructive urinary symptoms due to benign prostatic hyperplasia.

Adenoma↗
PubMed2002

[Prophylaxis for infectious complications of transurethral resections for prostatic hyperplasia].

A clinical-and-laboratory analysis was done in 76 patients who had undergone transurethal resection (TUR) for benign hyperplasia of the prostate (PH). Included into a complex clinical-and-laboratory examination were bacteriological urine tests, with the causative agent isolated and identified, analysis of the course of the affection, assessment of X-ray findings, clinical analyses of urine and blood. With the purpose of preventing pyo-septic complications before surgery and postoperatively, cephtasidim (fortum), a broad-spectrum antibiotic, was prescribed. The analysis of the clinical studies made suggests to us that a rational antibiotic prophylaxis involving the use of cephtasidim in those patients presenting with benign PH makes the risk of development of the post-TUR PH infectious complications getting lower.

Antibiotic Prophylaxis↗
PubMed1994

The post-transurethral resection of prostate syndrome: therapeutic proposals.

Absorption of large volumes of irrigation fluid during transurethral resection of the prostate (TURP) can produce hyponatremia, coma, blindness, and cardiorespiratory depression. This has been termed the "post-TURP syndrome." The pathophysiology and management of this syndrome are controversial. A case of severe post-TURP syndrome due to the absorption of hypotonic glycine irrigant is reported. This patient developed severe hyponatremia, slight hypo-osmolality, hyperglycinemia, hyperserinemia, hyperammonemia, and hypocalcemia. He became comatose, profoundly hypotensive, bradycardic, and transiently blind. Because of this combination of severe biochemical, neurologic, and hemodynamic abnormalities, we elected to treat this patient with hemodialysis. The biochemical and clinical manifestations resolved completely. The pathophysiology and treatment of this disorder are discussed and a role for hemodialysis is suggested.

Aged↗
PubMed1998

[Study on the duration of pyuria after transurethral resection of prostate].

A retrospective study was conducted on the duration of pyuria after transurethral resection of the prostate (TURP) and the factors affecting the duration in 273 patients, who were diagnosed as having benign prostatic hyperplasia (BPH) with postoperative resolution of pyuria among those who underwent TURP over the last ten years at our clinic. In the 273 patients, the mean (+/- SD) weight of the resected prostate was 13.2 +/- 10.2 g (range : 1-52 g), the mean operating time was 74.3 +/- 29.8 min (25-215 min), the duration of pyuria was 110.6 +/- 38.3 days (23-273 days), and the resected weight to operating time ratio was 0.172 +/- 0.093 g/min (0.018-0.500 g/min). There was a significant correlation between the duration of pyuria and the patient's age, resected weight, operating time, or resected weight/operating time ratio, resected weight being the most important factor. The surgeon, the postoperative antibiotics used, and the preoperative existence of pyuria did not have any significant effect on the duration of postoperative pyuria. Investigation after stratification by the resected weight in 10 g increments suggested that a shorter operating time was important to reduce the duration of postoperative pyuria, particularly in BPH patients with a resected weight of 20-29 g.

Age Factors↗
PubMed2004

[Effect of finasteride on intraoperative bleeding and irrigating fluid absorption during transurethral resection of prostate: a quantitative study].

OBJECTIVE: To evaluate the effect of pretreatment with finasteride in decreasing intraoperative bleeding and irrigating fluid absorption during transurethral resection of prostate (TURP). METHODS: Eighty patients with benign prostate hypertrophy undergoing TURP were divided into two groups: 40 patients were pretreated with finasteride for 7 to 14 days before TURP and 40 patients without pretreatment. Absorption of irrigating fluid was quantified by analyzing the serum concentration of gentamycin. Intraoperative blood loss was calculated based on hemoglobin concentrations before and after operation. RESULT: The whole blood loss, hemoglobin concentration of irrigating fluid used, blood loss per minute, blood loss per gram tissue resected, whole irrigation absorption, irrigation absorption per minute and per gram tissue resected in patients pretreated with finasteride were significantly less than those in patients without pretreatment (P<0.05). The blood transfusion volume, the incidence of hypotension and hyponatremia in patients pretreated with finasteride were significantly less than those in patients without pretreatment (P<0.05). CONCLUSION: Pretreatment with finasteride is of value in reducing intraoperative bleeding, irrigation absorption and perioperative complication during TURP.

Absorption↗
PubMed1997

Intrathecal pethidine: an alternative anaesthetic for transurethral resection of prostate?

We aimed to determine the usefulness of intrathecal pethidine as the sole anaesthetic for transurethral resection of prostate (TURP) while comparing the incidence of hypotension with intrathecal bupivacaine. A double-binded randomized prospective trial was conducted involving 40 patients for TURP. The patients were divided equally into two groups; group A received 2 ml 0.5% bupivacaine intrathecally and group B received 40 mg pethidine intrathecally. Changes in blood pressure and heart rate were measured over the first 30 minutes. The highest sensory block and the time to reach it were documented. The degree of motor blockade was also recorded. There was no significant difference in the incidence of hypotension. The pethidine group had significantly greater reduction in heart rate, a lower degree of motor block, shorter period before requests for postoperative analgesia but a higher incidence of sedation, nausea and vomiting. Intrathecal pethidine did not offer any advantage over intrathecal bupivacaine for TURP.

Aged↗
PubMed1994

[The influence of small dose intrathecal fentanyl on shivering during transurethral resection of prostate under spinal anesthesia].

Shivering during spinal anesthesia is a common complication in patients undergoing transurethral resection of prostate. The high incidence of shivering may be due to decreased core temperature secondary to peripheral vasodilation from sympathetic blockade and/or cold irrigation fluid. Shivering is known to increase O2 consumption, ventilation and cardiac output, which can result in morbidity to patients with limited cardiopulmonary reserves. The aim of this randomized double-blind study was to investigate whether 1.25 micrograms of intrathecal fentanyl administered would influence the incidence and severity of shivering in patients who underwent TURP under spinal anesthesia. In the present study, 79 patients with (n = 41) or without (n = 38) low dose fentanyl were study. The incidence of shivering was 65.8% in control group and 12.2% in the study group. The difference was statistical significance. The shivering grade (1.0 +/- 0 vs 1.76 +/- 0.7) and accumulative shivering scores (2.4 +/- 0.8 vs 12.5 +/- 5.6) were also significantly decreased in the study group (P < 0.05). Obviously, there was no difference in the incidence of pharmacologic side effect. We concluded that low dose intrathecal fentanyl is a god method for decreasing both incidence and severity of shivering during spinal anesthesia.

Aged↗
PubMedDate not supplied

Ultrastructural and biophysical studies on protein conformations of epithelium and stroma in benign prostatic hyperplasia before and after transurethral resection of the prostate.

The alterations in protein conformation of epithelium and stroma in human benign prostatic hyperplasia (BPH) undergoing prostatic needle biopsy (PNB) and transurethral resection of the prostate (TURP) were isolated in vitro and investigated using attenuated total reflectance (ATR)/Fourier transform infrared (FT-IR) microspectroscopy. Second-derivative spectral analysis and a curve-fitting program were used to verify and obtain the protein secondary conformation and composition of the samples. TURP uses an electric cutting heat but PNB is a nonheating process. The results indicate a predominantly higher proportion of beta-sheet conformation of the epithelium or stroma in BPH tissue at 1633 or 1630 cm(-1) in the amide I band, but after treatment with TURP, both maximum peaks shifted to 1644 or 1646 cm(-1) due to random coil structure, respectively. This conversion suggests that the heat generated by the cutting loop could increase the temperature in the tissue surrounding the prostate, thereby modifying the protein conformational structure of epithelium and stroma in BPH tissue.

Aged↗
PubMed1981

Incidence of urethral stricture after transurethral resection of prostate. Effects of urinary infection, urethral flora, and catheter material and size.

Urethral stricture is the most common complication of transurethral resection of prostate, occurring in up to 29 per cent of cases. A prospective trial was initiated to ascertain if the presence of positive urine and urethral bacterial cultures made any significant difference in urethral stricture incidence. One hundred patients were entered in the trial, 50 receiving latex catheters and 50 receiving Teflon catheters. There was no significant difference between the two groups in incidence of urethral stricture, and there was no correlation between positive urine and urethral bacterial cultures and stricture formation. It is suggested, therefore, tha urethral catheter material and size and the presence of organisms in the urine and in the urethra do not contribute significantly to the formation of urethral stricture following transurethral resection of the prostate.

Humans↗
PubMed1987

Antibiotic prophylaxis of urinary tract infection after transurethral resection of the prostate: a randomized study.

Transurethral resection of the prostate is associated with a major risk of postoperative infection. To evaluate the clinical and bacteriological efficacy of antibiotic prophylaxis with a single dose of netilmicin sulfate, we conducted a randomized study in 100 patients with sterile preoperative urine undergoing transurethral resection of the prostate. Of these patients 95 were evaluated: 47 were randomized to the control group and received an intramuscular injection of 1.5 ml. of a 0.9 per cent solution of sodium chloride 1 hour preoperatively and 48 were given an intramuscular injection of 150 mg. netilmicin sulfate in a volume of 1.5 ml. 1 hour preoperatively. Of the patients 16 in the control group (34 per cent) and only 1 in the treated group (2 per cent) had bacteriuria (greater than 10(5) bacteria per ml.) (p less than 0.001). This difference also was significant 2 and 5 days postoperatively (p less than 0.05 and p less than 0.001, respectively). One patient in the control group had bacteremia compared to none in the treated group. Clinical signs of infection were less common in the treated group. Sensitivity studies revealed that all of the organisms tested were sensitive to netilmicin sulfate. High concentrations of netilmicin sulfate were found in the urine collected at operation (162 +/- 112 micrograms per ml. urine).

Humans↗