After TURP, the symptom improved clinically with the mean international prostatic symptom score (IPPS) decreasing from 26 to 4 (84.6%). The mean average flow rate increased from 3 (range 2-7) before treatment to 13 (range 10-17) at after 3 months of follow up. The mean operative duration was 43.8 min (range 20-120). Most patients had their catheter removed within 48-72h and were discharged on the 3rd day after TURP. None of patients suffered a complication as TURP syndrome, urethral stenosis. Two serious heamorrhage (2.7%) required a blood transfusion. Six urinary tract infections were affected (8%).
Transurethral Resection of Prostate ; Prostate ; surgery

100 patients (54 in U.B hospital, 46 in Pitea) underwent TURP using a solution 2% ethanol as irrigating water; an expired breath alcohol meter was used2 to monitor ethanol in the patients breath every 5 min. P-fH6 was assessed before and after TURP in 99 patients. Other markers of hemolysis were also evaluated in the Swedish group. Result: 32 patients had detectable ethanol in their breath. There was a close correlation between the maximum ethanol reading during surgery and the level of p-fHb after TURP (r=0.90, p<0.001).
Hemolysis ; Transurethral Resection of Prostate ; surgery

These patients were admitted to hospital due to diuretic difficulty, increasing frequency of micturition (89.63%) and retention of urine (10.37%). Histopathological examination: Most of lesion are benign prostatic hyperplasia (98%, 15%). Carcinoma was detected only in 10 cases (1.85%).
Prostate ; Prostatic Hyperplasia ; diagnosis ; anatomy & histology ; surgery

Humans ; Male ; Prostate ; surgery ; Prostatic Hyperplasia ; surgery ; Transurethral Resection of Prostate ; instrumentation ; methods

OBJECTIVETo evaluate the therapeutic effect of transurethral enucleation of the prostate for treatment of benign prostatic hyperplasia in patients below 50 years of age.

METHODSTwelve patients with benign prostatic hyperplasia patients (mean age 48.2 years, range 46-49 years) underwent transurethral enucleation of the prostate. The middle lobe and two lateral lobes were enucleated with the preprosthetic sphincter and anterior fibromuscular stroma preserved during the operation. The patients were followed up to evaluate the lower urinary tract symptoms and sexual activity after the surgery.

RESULTSThe 12 patients were followed up for 3 to 6 months. The symptoms of lower urinary tract obstruction were improved obviously after the surgery, and the International Prostate Symptom Score (IPSS) decreased from 24±5.1 to 8.8±1.4 and peak urine flow rate (Qmax) increased from 8.1±4.2 ml/s to 20.1±4.2 ml/s at 3 months postoperatively. All the 12 cases had residual urine (12-44 ml) preoperatively, but after the surgery, only 4 still had residual urine of less than 30 ml. All the patients had normal erection function postoperatively, and 10 had normal ejaculation; the other 2 patients recovered normal ejaculation 3 and 5 months after the operation, respectively.

CONCLUSIONSTransurethral enucleation can alleviate the low urinary tract obstruction symptom and improve the sexual function by avoiding preprosthetic sphincter injury in relatively young patients with benign prostatic hyperplasia.

Humans ; Male ; Middle Aged ; Prostate ; surgery ; Prostatic Hyperplasia ; surgery ; Transurethral Resection of Prostate ; methods ; Treatment Outcome

Biopsy, Needle ; Humans ; Male ; Prostate ; pathology ; surgery ; Prostatic Neoplasms ; pathology ; surgery ; Transurethral Resection of Prostate

For more than nine decades, transurethral resection of the prostate remains the gold standard for the surgical treatment of lower urinary tract symptoms due to benign prostatic obstruction. The occurrence of urethral strictures after transurethral resection of the prostate is one of the major late complications and has been reported as the leading cause of iatrogenic urethral strictures in patients older than 45 years who underwent urethroplasty. Although several postulations have been proposed to explain the urethral stricture after transurethral resection of the prostate, the exact etiology of urethral stricture after TURP is still controversial. Suggested etiological factors of urethral stricture formation after transurethral resection of the prostate include infection, mechanical trauma, prolonged indwelling catheter time, use of local anesthesia, and electrical injury by a stray current. One single treatment option is not appropriate for all stricture types. The management of urethral stricture following transurethral resection of the prostate includes minimally invasive endoscopic methods, including urethral dilation and direct visual incision, or open surgical procedures with varying urethroplasty techniques. Although scientific studies focusing on urethral strictures after transurethral resection of the prostate are relatively limited and sparse, we can apply the principles of urethral stricture management before making decisions on individual stricture treatment.
Humans ; Male ; Middle Aged ; Prostate/surgery* ; Prostatic Hyperplasia/surgery* ; Transurethral Resection of Prostate/adverse effects* ; Urethra/surgery* ; Urethral Stricture/etiology*

OBJECTIVETo compare the postoperative depths of the coagulation zones and pathological changes between bipolar transurethral resection of the prostate with plasmakinetic energy (PKRP) and monopolar transurethral prostatectomy (TURP) in canines.

METHODSTwenty-five male dogs were randomly divided into a PKRP group (n = 12), a TURP group (n = 12) and a sham-operation control group (n = 1). The dogs were sacrificed, their prostates harvested at 0 week (immediately after surgery), 1 week, 2 weeks and 8 weeks postoperatively and sectioned for pathologic analysis and measurement of the coagulation zones.

RESULTSAt 0, 1 and 2 weeks after the operation, the coagulation depths were (237.73 +/- 20.12) microm, (113.03 +/- 16.65) microm and (106.01 +/- 16.36) microm in the PKRP group, and (200.75 +/-19.34) microm, (129.46 +/- 17.81) microm and (116.04 +/- 25.67) microm in the TURP group (P < 0.01). At 8 weeks, the coagulation zones completely peeled off and the wounds were covered by regenerated urothelial in both of the groups. At 0, 1, 2 and 8 weeks, different inflammatory reactions were observed in the prostates of the PKRP and TURP groups, with some glandular lumens beneath the coagulation zones expanded and epithelia damaged. However, none of these phenomena occurred in the sham-operation control group.

CONCLUSIONPathologically, PKRP and TURP inflicted basically similar effects on the prostate of the canine. However, the coagulation zone was deeper intraoperatively and became thinner postoperatively with the former than with the latter, which suggests that PKRP causes less bleeding and less penetrative thermal damage than TURP.

Animals ; Dogs ; Electrocoagulation ; Electrosurgery ; Male ; Prostate ; pathology ; surgery ; Transurethral Resection of Prostate ; methods

Holmium laser enucleation of the prostate (HoLEP), as a new hi-tech introduced from abroad, may bring about exactly the same results as open surgery, and is even superior to transurethral resection of the prostate (TURP), especially in handling the front prostate, with its advantages of minimal invasiveness, better safety, shorter operation time, less blood loss, and quicker recovery, which can be achieved through peeling off the prostate alongside the external sphincter and getting it removed in three parts or as a whole. So far, the author has accomplished more than 3 000 surgeries using this technique, without any serious complications. Any patient that can accept anesthesia and endoscopic surgery can be treated by HoLEP. This article presents an overview of the methods, skills and key points of HoLEP, gives a comprehensive analysis of HoLEP based on the anatomic features of the internal and external prostate, and offers a detailed introduction of the requirements of the operator, criteria for the accomplishment of the operation, and prevention and management of surgical damages.
Humans ; Lasers, Solid-State ; Male ; Prostate ; surgery ; Prostatectomy ; methods

OBJECTIVETo evaluate the effect of transurethral holmium laser enucleation of the prostate (HoLEP) for prostate adenoma greater than 100 g.

METHODSSixty BPH patients with the prostate larger than 100 g were randomized to two treatment groups of HoLEP (n = 32) and open prostatectomy (n = 28). Comparisons were made between the two groups in operating time, blood loss, bladder irrigating time, catheterization time and hospital stay, as well as in the international prostate symptom score (IPSS), quality of life (QOL) score, maximum urinary flow rate (Qmax) and postvoid residual volume (PVR) before and 3 months after the surgery.

RESULTSCompared with the open prostatectomy group, the operating time was significantly longer (P < 0.01) but the blood loss, mean bladder irrigating time, catheterization time and hospital stay were significantly less in the HoLEP group (P < 0.01). Three-month follow-up revealed that HoLEP and open prostatectomy resulted in a similarly significant improvement in IPSS, QOL, Qmax and PVR (P < 0.01 ), with no statistical difference between the two groups (P > 0.05).

CONCLUSIONHoLEP and open prostatectomy are equally effective procedures for removal of large prostate adenomas, but the former is a better surgical option for prostate adenomas larger than 100 g for its greater safety, less pain and faster recovery.

Aged ; Holmium ; Humans ; Laser Therapy ; Male ; Prostate ; surgery ; Prostatectomy ; methods ; Prostatic Hyperplasia ; surgery ; Transurethral Resection of Prostate ; methods ; Treatment Outcome