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PubMed1995

Blood loss during transurethral prostatic resection with continuous bladder irrigation.

A total of 120 men with benign prostatic hypertrophy were assigned randomly into three groups. Transurethral prostatic resections were performed in all patients. In Group I the operation was performed with continuous flow bladder irrigation, in Group II with suprapubic flow irrigation (without suction pump) and in Group III without continuous flow irrigation. Blood loss was determined by a colorimetric method. There were no statistically significant changes in blood loss between the groups of patients.

Blood Loss, Surgical↗
PubMed1979

Severe mannitol-induced hyponatremia complicating transurethral prostatic resection.

A case is presented in which the absorption of mannitol irrigation solution across prostatic veins resulted in severe hyponatremia in a patient undergoing transurethral prostatic resection. Since hyposmolality of the extracellular fluid was not seen because of the presence of mannitol the patient was asymptomatic despite a rapid decrease in the serum sodium concentration to 99 mEq./l. The importance of distinguishing dilutional hyponatremia from hyponatremia with normal or elevated osmolality is discussed.

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PubMed2006

A clinical outcomes and cost analysis comparing photoselective vaporization of the prostate to alternative minimally invasive therapies and transurethral prostate resection for the treatment of benign prostatic hyperplasia.

PURPOSE: We critically evaluated the clinical outcomes and cost characteristics of alternative procedural treatment options for symptomatic benign prostatic hyperplasia. MATERIALS AND METHODS: An outcomes and cost analysis was performed for benign prostatic hyperplasia treatments, including photoselective vaporization, microwave thermotherapy, transurethral needle ablation, interstitial laser coagulation and transurethral resection. Clinical outcomes were measured by the percent improvement in American Urological Association/International Prostate Symptom Score, the maximum uroflowmetry rate and quality of life score. An economic simulation model was constructed to estimate the expected cost of benign prostatic hyperplasia procedural therapies from a payer perspective. The model included costs of initial treatment, followup care, adverse events and re-treatment. Sensitivity and threshold analyses tested the impact of changing model inputs on base case results. RESULTS: Ablative therapies showed better improvement in symptom score, flow rate and quality of life score compared to thermotherapy procedures. Photoselective vaporization resulted in the largest beneficial changes in American Urological Association/International Prostate Symptom Score, the maximum uroflowmetry rate and the quality of life score at all time points evaluated, followed by transurethral resection and then interstitial laser coagulation. The estimated cost was lower for photoselective vaporization than for any other procedural option at any interval studied. Sensitivity analyses indicated that the results of baseline analyses were robust to reasonable changes in clinical and economic inputs to the model. CONCLUSIONS: Compared to alternative treatment options photoselective vaporization of the prostate is a clinically efficacious and cost-effective treatment for symptomatic benign prostatic hyperplasia.

Cost-Benefit Analysis↗
PubMed1985

Sexual life following 'minimal' and 'total' transurethral prostatic resection.

81 otherwise healthy men with an average age of 67 years and verified prostatic hypertrophy were randomized into two groups for either 'minimal' or 'total' transurethral prostatic resection (TUR-P). Interviews on sexual life were made preoperatively and 6 and 12 months postoperatively. 58 men (72%) were prior to the operation sexually active. 18 (31%), mainly men of advanced age, discontinued sexual activity following TUR-P. 40 (69%) remained active. 19 had retrograde ejaculation. No significant difference was found between 'minimal' and 'total' TUR-P concerning the effect on sexual activity and the occurrence of retrograde ejaculation.

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PubMed1985

The effect of transurethral prostatic resection on the incidence of osseous prostatic metastasis.

Of 169 patients with a minimum of 4 years follow-up treated definitively with irradiation for adenocarcinoma of the prostate, 100 had transurethral prostatic resection (TURP) before treatment. In comparing that group with the group who did not have TURP, osseous metastases developed in 28% versus 22%, respectively. Further stratification by tumor grade and stage failed to show TURP-dependent tumor dissemination, whereas the incidence of bony metastasis increased progressively with decreasing tumor differentiation and advancing tumor stage.

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PubMed2002

Acute renal failure directly caused by hemolysis associated with transurethral resection of the prostate.

Transurethral resection of the prostate (TURP) for the treatment of benign prostatic hyperplasia may lead to TURP syndrome, and in some cases, acute renal failure can develop. Hemolysis does happen during TURP. Whether hemolysis itself leads to acute renal failure merits discussion. We report a patient with chronic renal insufficiency who developed oliguric acute renal failure immediately as a major complication after TURP. The renal function of this patient recovered after six hemodialysis sessions, and the patient continued to do well in the subsequent follow-up period.

Acute Kidney Injury↗
PubMed1991

Hyponatraemia after transurethral resection of the prostate.

Transurethral resection (TUR) syndrome is a complication of transurethral resection of the prostate characterized by bradycardia, hypotension and postoperative confusional state, which is generally attributed to hyponatraemia occurring during or immediately after operation. In a prospective study of 100 consecutive patients undergoing transurethral resection of the prostate, changes in serum sodium were estimated before and after operation and correlated with various parameters including weight of prostate resected, volume of irrigant fluid and resection time. Seven patients showed a significant drop (greater than 10 mmol/litre) in serum sodium: two of these had the clinical features of TUR syndrome and one of them died. The pathogenesis and management of this syndrome are discussed.

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PubMed1997

Care of the patient undergoing transurethral resection of the prostate.

Transurethral resection of the prostate (TURP) for benign prostatic hypertrophy is a common surgical procedure in the United States. Left untreated, benign prostatic hypertrophy can lead to detrimental consequences such as renal failure from urinary obstruction. Although TURP is a common procedure, it is not without risk. Complications can occur, and the perianesthesia nurse must be familiar with them and their treatment. Complications related to the surgical procedure and the anesthesia technique must be assessed and treated quickly to prevent morbidity and mortality in these patients. The perianesthesia nurse is instrumental in managing and preventing complications associated with transurethral resection of the prostate.

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