SEARCH · PubMed Health

Results for “Transurethral Resection of Prostate”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 685 records · Page 38Linked to original sources

PubMed1989

Perioperative antibiotic prophylaxis for transurethral resection of the prostate: is it justifiable?

The role of perioperative antimicrobial prophylaxis in transurethral resection of the prostate remains controversial. A total of 110 patients with preoperative sterile urine undergoing transurethral resection of the prostate was included in this open, prospective and randomized study to compare the prophylactic role of cefoperazone to no antibiotic prophylaxis. Patients were well matched between the 2 groups on all essential characteristics and risk factors at baseline. Owing to the strict selection criteria and aseptic measures used, the low incidence of postoperative urinary tract infections in the control group (1.8 per cent) compared to none in the cefoperazone group made conclusions and generalization limited due to sample size. In view of the extremely low infection rate it is doubtful that antibiotic prophylaxis had any beneficial role in this selected population.

Aged↗

PubMed1990

Visual disturbances, serum glycine levels and transurethral resection of the prostate.

Transient visual disturbances have been noted in patients undergoing transurethral resection of the prostate. It has been suggested recently that these visual aberrations were secondary to high serum concentrations of glycine from the intravasation of irrigant solutions used during the procedure. We prospectively studied visual acuity, serum electrolytes, glucose, ammonia and glycine concentrations in 18 patients undergoing transurethral resection of the prostate. Of our patient population 22% experienced significant decreases in visual acuity. We found that all patients had significantly elevated serum glycine concentrations but that there was no correlation of visual symptomatology with serum electrolyte or glucose concentrations. Our data further suggest that impeded metabolism of glycine may be more important than the absolute serum concentration in symptomatic patients.

Ammonia↗

PubMed1996

In situ transitional cell carcinoma involvement of prostatic urethra: bacillus Calmette-Guérin therapy without previous transurethral resection of the prostate.

OBJECTIVES: Bacillus Calmette-Guérin (BCG) has demonstrated both the efficacy in patients with carcinoma in situ (CIS) of the bladder and the penetration in the prostate (granulomas) after endovesical treatment. We treated patients with CIS of the prostatic urethra with bladder instillations of BCG without previous transurethral resection to assess the local therapeutic effect. METHODS: Eighteen patients with CIS of the prostatic urethra (15 multifocal CIS and 15 associated to superficial bladder carcinoma) were treated with endovesical instillations of 81 mg of BCG Connaught weekly for 6 weeks. RESULTS: After a mean follow-up of 31 months, 14 of 18 patients had complete response, 3 had progression (2 in the prostate and 1 in the bladder); diffuse CIS of the bladder persisted in 1 patient. Three patients required cystectomy and 1 underwent palliative transurethral resection. Fifteen patients are alive with no evidence of disease, 2 patients died due to progression of the disease, and 1 is alive with tumor. CONCLUSIONS: The presence of CIS in the prostatic urethra can be managed with endovesical BCG as initial treatment with fairly good success. There is no need for transurethral resection, even though a loop biopsy may have to be obtained at the first control examination to make sure there is no stromal invasion.

Administration, Intravesical↗

PubMed2000

The detection of prostate cells by the reverse transcription-polymerase chain reaction in the circulation of patients undergoing transurethral resection of the prostate.

OBJECTIVE: To determine whether prostate cells are disseminated into the circulation of patients after transurethral resection of the prostate (TURP), as assessed by a reverse transcription-polymerase chain reaction (RT-PCR) assay for prostate specific antigen (PSA) mRNA. PATIENTS AND METHODS: Fifty-one patients, comprising 34 with benign prostatic hyperplasia (BPH) and 17 with prostate cancer who were undergoing routine TURP, had blood samples taken before and 30 min after surgery. The blood mononuclear cell layer was isolated by density-gradient centrifugation and total RNA extracted. Complementary DNA was synthesized by RT of the RNA. The target PSA sequence was amplified by PCR with specific PSA primers and the product detected on agarose-gel electrophoresis with ethidium bromide staining. RESULTS: Five patients (all with prostate cancer) were positive on PSA RT-PCR before surgery and remained positive after TURP. Of the remaining 46 patients, five (11%; three with BPH and two with cancer) changed from a negative to a positive result after TURP. CONCLUSION: In a proportion of patients TURP causes the dissemination of prostate cells into the circulation which are then detectable by RT-PCR of PSA mRNA.

Aged↗

PubMed1992

Mortality, morbidity and complications following transurethral resection of the prostate for benign prostatic hypertrophy.

A total of 388 men undergoing transurethral resection of the prostate for benign prostatic hypertrophy during 1988 entered a prospective cohort study designed to examine the outcome of surgery during postoperative year 1. Self-administered questionnaires were completed preoperatively, and at 3, 6 and 12 months postoperatively. The surgeons completed 1 questionnaire shortly after surgery and another questionnaire 3, 6 or 12 months later. The mortality rate during the 12 months of followup was 2.8% (11 deaths). The surgeons reported perioperative complications in 14% of the patients and immediate postoperative complications, excluding urinary tract infections, in 17%. During the first 3 months postoperatively 38% of the patients reported incontinence and 25% had a urinary tract infection. Between 6 and 12 months postoperatively only 12% of the patients were troubled by either condition. The postoperative prevalence of impotence (24%) did not alter during followup and was similar to that reported preoperatively (22%). Of the patients 74% reported feeling better and 78% experienced a decrease in the overall level of symptoms postoperatively. The improvement in symptom levels was greatest in those with the most severe preoperative symptoms, and obstructive symptoms were alleviated slightly more than irritative symptoms.

Adult↗

PubMed1994

Survival after transurethral resection of the prostate: a 10-year followup.

Among 141 men who underwent transurethral resection of the prostate from late 1979 to early 1980 followup for 10 years was done, registering total mortality rate and individual dates of death. The mortality of the group was compared to an age-matched group from the background population of men for each of the 10 years. During the observation period the mortality of the group as a whole as well as that of the patients 65 years old or older at operation were equal to that of the background population at all times. Withholding recommendation of transurethral resection of the prostate in favor of other types of prostatic surgery on the grounds of a higher long-term mortality rate is not supported by our material.

Aged↗

PubMed2006

Rapid communication: bipolar PlasmaKinetic transurethral resection of the prostate: reliable training vehicle for today's urology residents.

BACKGROUND AND PURPOSE: With the improvement of medical therapy and minimally invasive surgical treatments for benign prostatic hyperplasia, the number of transurethral resections of the prostate (TURPs) done in training is decreasing. With fewer TURPs being performed, proficiency in this basic urologic technique has decreased, causing longer resection times. This often leads to a higher risk of fluid absorption, water toxicity, and hyponatremia (TUR syndrome). We examined the safety of bipolar electrocautery TURP (saline TURP) with the Gyrus PlasmaKinetic system using normal saline as irrigant. PATIENTS AND METHODS: Twenty-one men aged 54 to 85 years (median 70.0 years) underwent saline Plasma- Kinetic TURP from June 2002 to August 2003. Serum sodium, chloride, hemoglobin, and hematocrit were measured 1 hour prior to and 1 hour after TURP. Resection time, tissue weights, hospital stay, and catheter time were recorded and analyzed. RESULTS: The median preresection and postresection sodium concentrations were 139.0 mEq/mL and 140.0 mEq/L, respectively (ranges 130-142 mEq/L and 134-143 mEq/L). The corresponding chloride values were 106.5 mEq/L and 109.0 mEq/L (ranges 102-114 mEq/L and 106-116 mEq/L), and the hemoglobin and hematocrit values were 13.4 g/dL and 40.1 g/dL (8.7-15.2 g/dL and 33.7-46.7 g/dL) and 12.0 g/dL and 36.6 g/dL (8.2-14.4 g/dL and 27.5-43.7 g/dL), respectively. The median resection time was 65 minutes (range 45-140 minutes), and the median resected tissue weight was 20 g (range 5-61 g). There was no statistically significant difference between the preresection and postresection sodium concentrations, and no patient exhibited any clinical sign of TUR syndrome. CONCLUSION: Gyrus PlasmaKinetic TURP using normal saline as the irrigant is a safe alternative to and is technically no different from traditional monopolar TURP. The system also provides the longer time needed to train urology residents without compromising patient safety.

Aged↗

PubMed2003

[Modified technique for transurethral resection of the prostate with suprapubic drainage and local anesthesia].

PURPOSE: To establish a technique for transurethral resection of the prostate (TURP), combining the use of local anaesthesia with an Amplatz suprapubic tube, in patients at high surgical risk. MATERIALS AND METHOD: A study was carried out in 32 patients who underwent TURP with a 30 F Amplatz suprapubic tube following local anaesthesia. This technique was indicated where surgery presented a general risk, in elderly patients, and for patients refusing to undergo spinal intradural or general anaesthesia. The mean age of the patients was 70 years (61-82 years). The risk of surgery was assessed according to the ASA classification. RESULTS: According to the ASA classification, 7 patients were ASA III (21.9%), and 25 patients were ASA IV (78.1%). In 31 of the 32 patients the operation was completed in one session. When questioned about the pain they felt, 11 patients reported no pain, 12 slight discomfort and 3 occasional pain. In the latter three patients, intravenous sedation was enhanced with 0.1 mg etomidate per kg body weight. The volume of the resected fragments ranged from 18 to 120 ml, with a mean of 47 ml, except in one patient with 205 ml who required two treatment sessions. CONCLUSIONS: Large prostate resection in patients at high surgical risk was performed comfortably using a combination of local anaesthesia and an Amplatz suprapubic tube. This procedure is one possible option to be considered as an alternative to other treatments.

Adenocarcinoma↗

PubMed2006

Low PAI-1 activity in relation to the risk for perioperative bleeding complications in transurethral resection of the prostate.

INTRODUCTION: Low levels of plasminogen activator inhibitor type 1 (PAI-1) have been associated with increased risk for perioperative bleeding in some case reports. The aim of this study was to investigate prospectively whether low PAI-1 activity increases the risk for perioperative bleeding in patients undergoing transurethral resection of prostate, an organ with high fibrinolytic activity. PATIENTS AND METHODS: 62 patients with benign prostatic hyperplasia planned for transurethral resection were included. Blood samples for PAI-1 were taken together with other routine preoperative blood samples 1week before surgery but analyzed after the hospitalization. The intraoperative blood loss was determined by measuring the amount of hemoglobin in the irrigating fluid. The postoperative blood loss was estimated from calculations of hemoglobin mass (Hb mass), which is a product of hemoglobin concentration and blood volume. Hb mass was calculated before surgery and on the day of discharge, and was adjusted for intraoperative blood loss and transfused Hb mass. Bleeding complications were defined as re-operation due to bleeding, more than 40ml intraoperative bleeding/g resected prostatic tissue or postoperative blood loss corresponding to more than 100g of hemoglobin. RESULTS: Bleeding complications were observed in 3 of 4 (75%) patients with low PAI-1 levels, defined as <1U/ml, and in 16 of 58 (28%) patients with PAI-1 levels >1U/ml (P=0.082). After adjustment for resection time, resected prostatic mass and systolic blood pressure this became borderline significant (odds ratio 11.8; 95% confidence interval 1.00-139; P=0.05). CONCLUSION: Low PAI-1 activity may contribute to the risk of bleeding after transurethral resection of the prostate.

Aged↗

PubMed2002

How did the endoscopic video camera change our practice in transurethral resection of the prostate? A retrospective study of 200 cases.

PURPOSE: Video camera-assisted transurethral resection of the prostate (TURP) is an invaluable teaching tool and provides physical comfort to the surgeon. However, whether it improves technical skills and reduces complications rates and hospital stay has not been well documented. PATIENTS AND METHODS: We retrospectively reviewed 100 cases of video camera-assisted (VCA) TURP and 100 cases of non-video camera-assisted (NVCA) TURP randomly chosen from 1490 cases performed over a 5-year period. The patients' mean age was similar in the two groups (70 years in the NVCA group and 71 years in the VCA group). RESULTS: The mean weight of prostatic chips was 33.2 g in the VCA and 19.02 g in the NVCA group (P < 0.05). The mean operative time was identical in the two groups (VCA 41 minutes and NVCA 42.2 minutes). The mean postoperative hospital stay was shorter in the VCA group than in the NVCA group (1.56 and 3.39 days, respectively) (P < 0.05), as was the urinary drainage time (1.68 and 4.04 days, respectively) (P < 0.05). In the NVCA group, three patients had profuse hemorrhage necessitating blood transfusions and two had TURP syndrome, while in the VCA group, one patient had TURP syndrome and no patient experienced intraoperative or postoperative hemorrhage. Urethral stricture was less frequent in the VCA group than in the NVCA group (1% and 3%, respectively). CONCLUSIONS: With video camera-assisted TURP, we resected larger prostate glands with minimal intraoperative bleeding, better hemostasis, and a shorter hospital stay.

Aged↗

PubMed1986

Rapid massive irrigating fluid absorption during transurethral resection of the prostate.

Absorption of irrigating fluid is common during transurethral resection (TUR) of the prostate. Eleven patients were monitored peroperatively during TUR with measurements of bladder pressure, arterial blood pressure, central venous pressure and determinations of serum sodium as well as fluid balance. A rapid massive irrigating fluid absorption occurred in one case. The clinical course and data from the patient monitoring makes it possible to study early manifestations of irrigating fluid absorption. The bladder pressure recordings show that maximum intravesical pressures were not higher during the phase of rapid massive absorption as compared to periods without absorption.

Absorption↗

PubMed2006

A prospective randomized study for comparing bipolar plasmakinetic resection of the prostate with standard TURP.

OBJECTIVES: To compare clinical results of plasmakinetic (PK) resection vs. standard monopolar resection of the prostate, i.e. transurethral resection of the prostate (TURP). MATERIALS AND METHODS: 48 patients were included in this study between January 2003 and October 2003. They were randomized into two groups (TURP:PK) with a ratio of 1:1. PK resections (n = 24) were carried out by using PlasmaKinetic Tissue Management System (Gyrus Medical Ltd, Cardiff, UK) and PlasmaSect electrodes. TURPs (n = 24) were done by using a 26-Fr continuous-flow resectoscope and Karl Storz 27040 electrodes. Patients were assessed for safety and efficacy by measuring the IPSS and maximum flow rates at 1, 3, 6 and 12 months and residual urine measurement at 3, 6 and 12 months and transrectal ultrasonography at 6 months. RESULTS: The patients' ages ranged from 50 to 82 (mean 64 +/- 10) years. Groups were similar for operation time, bleeding score, resected tissue, catheterization time and irrigated volume. Mean serum Na levels at the end of the operation were 141.7 +/- 5.1 in the TURP group and 145.2 +/- 4.4 in the PK group (p = 0.013). The IPSS, QOL score and Q(max) had improved significantly in the postoperative period without any differences in either group. CONCLUSIONS: The main advantage of PK resection seems to be decreasing the risk of TUR syndrome, thus, larger prostates could be treated without a time limitation, theoretically. However, this technique brings no advantages in terms of intra- and postoperative bleeding, hospital stay, operation time and late complications.

Aged↗

PubMed1982

Disseminated cryptococcosis after transurethral resection of the prostate.

A 63-year-old man presenting with acute retention and dysuria underwent transurethral resection of the prostate for suspected benign prostatic hypertrophy. Ten days postoperatively he developed disseminated cryptococcosis. Re-examination of the prostatic chips revealed cryptococcal prostatitis. Treatment consisted of amphotericin, flucytosine and transfer factor along with wedge resection of a pulmonary toruloma. He remains well 12 months after cessation of treatment. This appears to be the first case report in Australia of cryptococcal prostatitis with dissemination after transurethral resection of the prostate.

Amphotericin B↗

PubMed2004

Post-brachytherapy transurethral resection of the prostate in patients with localized prostate cancer.

PURPOSE: We assessed the rate and results of transurethral resection of the prostate (TURP) in patients previously treated with brachytherapy as monotherapy for localized prostate cancer. MATERIALS AND METHODS: From May 1998 to May 2003, 600 patients with localized prostate cancer were treated with brachytherapy at our institution. Brachytherapy was performed as monotherapy with curative intent for clinically localized prostate cancer without adjuvant treatment in patients with clinical stages T1c (68.4%) or T2a (31.6%) disease. -Iodine and palladium implants were used in 583 and 7 patients, respectively. A real-time interactive implantation technique was used in all but the first 17 patients, who were treated using a preplanned technique. RESULTS: Of the 600 patients 19 (3.1%) underwent TURP after brachytherapy. Among the patients with acute urinary retention the median interval between prostate brachytherapy and urinary retention was 2 months (range 0.5 to 32). No TURP was done within 6 months after implant. The median interval between prostate brachytherapy and TURP was 7 months (range 6 to 41) and median prostate specific antigen (PSA) before TURP was 0.5 ng/ml (range 0.04 to 3.4). In the 19 patients the median weight of resected prostatic tissue was 8 gm (range 2 to 19) and 1 to 11 seeds were removed (median 5). The perioperative and postoperative courses were uneventful. There was no TURP related incontinence. With a median followup of 28 months after brachytherapy (range 7 to 48) no patient had clinical or biochemical evidence of disease progression, and for the group of 19 patients who underwent TURP median serum PSA at the end of followup was 0.38 ng/ml (range 0.03 to 3.4). CONCLUSIONS: After brachytherapy as monotherapy, TURP can be done safely if indicated. In our experience the resection of prostatic tissue along with a limited number of seeds at least 6 months after implantation did not impair PSA based biological and clinical results of brachy-therapy.

Aged↗

PubMedDate not supplied

The use of ceftriaxone in the prevention of urinary tract infection in patients undergoing transurethral resection of the prostate (TUR-P).

We evaluated 101 patients undergoing transurethral resection of the prostate in this open randomized study in which 51 received antibiotic prophylaxis and 50 did not (control group). In those patients receiving antibiotics, ceftriaxone 1 g was administered intravenously within 1 h before transurethral prostatectomy and a second dose was given 3-4 days postoperatively, within 1 h before the suprapubic catheter was removed. The groups had similar clinical and demographic characteristics. During the 28-day study period, bacteriuria appeared in six ceftriaxone-treated patients and in 20 control patients (p < 0.005). On days 3-4 after the resection, only two patients who had received ceftriaxone had bacteriuria compared with 14 in the control group (p < 0.005). In addition, the incidence and duration of fever and length of hospitalization were shorter in the patients treated with ceftriaxone. In conclusion, these results support the use of prophylactic antibiotics in transurethral prostatectomy, even in patients at low risk of developing bacteriuria.

Aged↗

PubMed2006

Transurethral resection of the prostate with a bipolar tissue management system compared to conventional monopolar resectoscope: one-year outcome.

The purpose of the present study was to evaluate the efficacy and safety of bipolar transurethral prostatectomy (TURP) using the Gyrus PlasmaKinetic System compared with conventional monopolar TURP. This study included 102 patients with benign prostatic hyperplasia (BPH) who underwent TURP from January 2003 to March 2005. In all, 49 consecutive patients had bipolar and 53 had monopolar TURP. All patients were assessed by preoperative and postoperative International Prostate Symptom Score (IPSS), uroflowmetry, transrectal ultrasonography, operative time, weight of resected tissue, change in serum sodium and hemoglobin, duration of catheter use, length of hospital stay, and complication rates. Significant improvement was seen postoperatively in both groups, and no difference was observed in the resection time, weight of resected tissue, change in serum sodium and hemoglobin, improvement of IPSS and peak flow rate (Qmax), or complication rates over the 12-month follow-up in both groups. There was, however, a significant difference in duration of catheter use and hospital stay. Duration of catheter use (2.28 days vs. 3.12 days) and hospital stay (3.52 days vs. 4.27 days) were shorter in the bipolar group (p = 0.012 vs. p = 0.034, respectively). Our results demonstrate that bipolar TURP using the Gyrus Plasma Kinetic System is as effective as conventional monopolar TURP with the additional advantage of reduced length of catheter use and hospital stay. Bipolar TURP is a promising new technique that may prove to be a good alternative to conventional TURP in the future.

Aged↗

PubMed2000

Two-year results of transurethral resection of the prostate versus four 'less invasive' treatment options.

OBJECTIVE: The aim of this study was to compare the efficacy or transurethral resection of the prostate (TURP) versus four less invasive treatment options during a 2-year follow-up. MATERIAL AND METHODS: 95 elderly men with lower urinary tract symptoms due to benign prostatic hyperplasia (BPH) were assigned prospectively to the following five treatment arms; transurethral resection of the prostate (TURP; n = 28), transurethral electrovaporization (TUVP; n = 17), visual laser ablation of the prostate (VLAP; n = 17), transrectal high intensity focused ultrasound (HIFU; n = 20) and transurethral needle ablation (TUNA); n = 15). Preoperative workup included the International Prostate Symptom Score (IPSS), uroflowmetry, post-void residual volume (PVR), prostate volume determined by transrectal ultrasonography and a multichannel pressure flow study. Postoperative follow-up at 6, 12, 18 and 24 months included assessment of IPSS, PVR and uroflowmetry. RESULTS: At study entry, patients assigned to one of the five treatment arms were comparable with respect to age, peak flow rate (Q(max)), IPSS, prostate size and the degree of bladder outflow obstruction. During study, 1 patient in the TURP group (4%) required a secondary TURP, as compared to 23.5% (n = 4) after TUVP, 26.7% (n = 4) after VLAP, 15% (n = 4) after HIFU and 20% (n = 3) following TUNA. In patients not subjected to a secondary procedure, the IPSS decreased a mean 13. 9 after TURP, as compared to 12.7 after TUVP, 12.9 after VLAP, 7.0 after HIFU, and 9.8 after TUNA. Q(max) increased 11.5 ml/s (mean) after TURP, as compared to 11.1 ml/s after TUVP, 5.6 ml/s after VLAP, 2.5 ml/s after HIFU and 2.3 ml/s after TUNA. CONCLUSION: In up to a quarter of the patients, a secondary TURP is performed within the first 2 years after 'less invasive' procedures. These data underline the need for long-term studies to reliably assess the role of less invasive procedures and to indicate that TURP is still competitive.

Aged↗

PubMed2003

Bladder explosion during transurethral resection of the prostate.

A case of bladder explosion with wide rupture during transurethral resection of the prostate (TURP) is reported. Immediate cystography was performed and the patient was promptly operated; the postoperative course was uneventful. Intravesical explosion is caused by explosive gas formation and the more dangerous combination is the mixture of air and hydrogen; therefore, the introduction of air during TURP is necessary in order to produce a bladder explosion. This unusual complication of a common urological procedure is rare but serious, and should it arise always requires immediate surgical correction.

Aged↗