Objectives: to investigate the effectiveness and reliability of the combination of optical cystolithotripsy (OC) and transurethral prostatectomy (TURP) for the treatment of bladder calculi and obstructive benign prostates enlargement (BPE). Patients and methods: from September 1999 to December 2003, 63 patients who had bladder stones and BPE were treated with combined OC and TURP; 45 patients who had bladder stones with no infravesical obstruction were treated with OC alone. In the same period, the records of random selection of 561 patients with BPE were treated by TURP. The operative duration time, the length of hospital stay, the duration of urethral catheterization, outcome and complication of the procedures for each patient were reviewed. Results: The mean duration of surgery were significantly longer with combined OC and TURP than with OC or TURP alone (p<0.05), but not of hospital stay and urethral catheterization. Stones free rates were 100% after OC alone and combined OC and TURP. The postoperative average mean peak flow rates were 13.2 ml/s in the combined OC and TURP group and were 13.7 in the TURP alone group. The complication rates were 13.6% for the TURP procedure, 5% for the OC alone and 21% for the combined OC and TURP (p<0.05). Conclusion: Simultaneous treatment with OC and TURP did not change the effectiveness of these procedures, but caused additional morbidity.
Prostatectomy ; Transurethral Resection of Prostate

No abstract available.
Prostatectomy*

PURPOSE: The purpose of this study was to evaluate the annual changes in prostate variables and style of surgical treatment of patients with benign prostatic hyperplasia (BPH) over the past 12 years. MATERIALS AND METHODS: The subjects were 918 patients (January 1999-November 2010) who were treated by either open prostatectomy or transurethral resection of prostate (TURP). Every year, the performance ratio between open prostatectomy and TURP was evaluated. Before surgery, total and transitional zone volumes of the prostate were measured by transrectal ultrasonography (TRUS). After surgery, resection weight and residual volume of the prostate were measured by TRUS. RESULTS: From 2001 through 2010, the performance ratio of TURP increased greatly from 89% to 97%. During 1999 to 2010, the total volume of the prostate increased from 40.0 cc to 55.0 cc in the TURP group and from 74.1 cc to 116.7 cc in the open prostatectomy group. During 1999 to 2010, the mean resection volume of the TURP group increased from 2.3 cc to 20.1 cc. Also, the mean resection volume of the open prostatectomy group increased from 59.3 cc to 114.3 cc. During 1999 to 2003, the resection time of the TURP group decreased from 72.9 minutes to 43.2 minutes. CONCLUSIONS: During 1999 through 2010, the performance ratio between open prostatectomy vs TURP was high for TURP. The total volume and resection volume of the prostate increased annually, and the resection time decreased annually.
Humans ; Prostate ; Prostatectomy ; Prostatic Hyperplasia ; Residual Volume ; Transurethral Resection of Prostate

PURPOSE: We compare the effectiveness and safety of transurethral resection of the prostate(TURP) with those of open prostatectomy for large benign prostatic hyperplasia(BPH), that was over 70cc of prostate volume. MATERIALS AND METHODS: Seventy-one patients with a prostate volume of more than 70cc and who received TURP were classified to group A, while 41 patients who received open prostatectomy were classified to group B. The International Prostate Symptom Score(IPSS), maximal flow rate(Qmax) and post-voiding residual urine(PVR) volume were evaluated preoperatively and at 1, 3, 5 and over 5 years postoperatively. RESULTS: The postoperative IPSS, Qmax and PVR were significantly improved after 1 year(p<0.05). The IPSS and Qmax showed no significant differences between the two groups for 1, 3, 5 and over 5 years after operation(p>0.05). The PVR was significantly lower in group B at 1 year post-operation(p<0.05), but there were no significant difference between the groups for 3, 5 and over 5 years after operation(p>0.05). There were 7 cases(9.8%) of re-operation and 3 cases(4.2%) of re-medication after 5 years of operation. There were no major complications for each group. CONCLUSIONS: On comparison between TURP and open prostatectomy for the patients with large BPH, there were no significant difference in effectiveness and safety for 5 years. Even for the patients with BPH that showed a high volume, TURP is an effective operation that can replace open prostatectomy.
Humans ; Prostate ; Prostatectomy ; Prostatic Hyperplasia ; Transurethral Resection of Prostate

Among the 65 patients undergoing transurethral resection of the prostate from 1985 to 1988, the complication incidence was significantly higher in 25 patients whose weight of resected prostate was above 20 gm than in 40 patients below 20 gm (p<0.05). So to choose mote proper surgical method, the results of operation, motality and morbity of these 25 TURP patients were compared with 35 open prostatectomy patients whose weight of resected prostate was between 20 gm and 60 gm during same period. The mean incidence of complication for open prostatectomy (60%) was nearly twice that of the TURP (32%) (p<0.05). The age of the patient had no significant influence on the incidence of complication in both groups. In case of the weight of resected prostate below 40 gm complication incidence for the TURP (26.3%) was significantly lower compared with open prostatectomy(66.7%) (p<0.05), but in case of above 40 gm there was no significant difference in both groups. In case of the length of resection below 120 min complication incidence was significantly low in TURP (21.4%) compared with open prostatectomy (61.5%) (p<0.05), but in case of above 120 min. there was no significant difference in both groups. In the open prostatectomy there was no increase in complication incidence by the weight of the gland and the operation time, but in TURP, complicat,40 gm incidence was definitely increased when either weight of the resected prostate was above 40 gm or length of resection was above 120 minutes. Therefore, it seems that TURP is preferable surgical method for benign prostatic hypertrophy unless open surgery is necessarily indicated.
Humans ; Incidence ; Prostate ; Prostatectomy* ; Prostatic Hyperplasia* ; Transurethral Resection of Prostate

PURPOSE: We performed transurethral resection of prostate(TURP) in benign prostatic hyperplasia(BPH) patients with large prostate greater than 100 g and evaluated the efficacy of TURP compared with open prostatectomy. MATERIALS AND METHODS: From June 1998 to January 2006, all 26 patients with symptomatic BPH patients with large prostate greater than 100 g were entered into the study. 7 patients underwent open prostatectomy (open group) and the other 19 patients underwent TURP(TURP group). The pre-operative evaluation included International Prostate Symptom Score(IPSS), quality of life(QoL), peak urinary flow rate(Qmax), satisfaction index and transrectal ultrasonography, operation time, weight of resected tissue, postoperative hospital stay and complications were noted. RESULTS: Between two groups there were no statistically significant differences in pre-operative data. In open group resected tissue was larger than TURP group, however, hospital stay and operation time were longer, and operation-related complications happened more frequently than TURP group. There were no statistically significant differences in postoperative IPSS, QoL, Qmax and satisfaction index between the two groups. CONCLUSION: Compared with open prostatectomy, TURP can be safely performed for treating symptomatic BPH greater than 100 g in size.
Humans ; Length of Stay ; Prostate* ; Prostatectomy* ; Prostatic Hyperplasia ; Transurethral Resection of Prostate* ; Ultrasonography

PURPOSE: Although open prostatectomy is usually considered when the prostate gland is greater than 50cc, it needs an incision and relatively longer hospital days and has a potential for intraoperative hemorrhage. For these reasons, we performed staged transurethral resection of the prostate (TURP) consecutively instead of open prostatectomy for benign prostatic hyperplasia (BPH) patient with a prostate larger than 50cc. MATERIALS AND METHODS: Among total 30 BPH patients with a prostate larger than 50cc in volume, 14 patients underwent immediate repeat TURPs (group A) and 16 patients underwent suprapubic prostatectomies (group B). Preoperative international prostate symptom score (IPSS), uroflowmetry, pressure-flow study, operative data, postoperative immobilization period because of hematuria and other complications were reviewed. IPSS and uroflowmetry were followed up to 6 months after operation. RESULTS: There were no statistically significant differences in age, preoperative IPSS and Qmax between the two groups. At 6 months after the operation mean Qmax and IPSS were improved in both groups significantly, and while Qmax was higher in the group B, there was no significant difference in decreasing IPSS. In the group A, hospital stay and immobilization period were shorter and there was no patient who needed transfusion because of bleeding or suffered from TUR symdrome. In contrast, 9 (75%) patients needed transfusion because of bleeding in the group B. CONCLUSIONS: Staged TURP is a valuable surgical method with respect to absence of incision, effective symptom improvement, short hospital stay and postoperative immobilization perod and low risk of complications such as bleeding and TUR syndrome in symptomatic BPH patient who has a prostate volume over 50cc.
Hematuria ; Hemorrhage ; Humans ; Immobilization ; Length of Stay ; Prostate ; Prostatectomy* ; Prostatic Hyperplasia* ; Transurethral Resection of Prostate*

The results of 97 transurethral resections of the benign prostatic hypertrophy are compared with 78 open prostatectomies performed from 1971 through 1981. The following results are obtained as below: 1. 33.0% of the patients subjected to TUR and 39.7% of the patients subjected to the open surgery were associated with one or more other genito-urinary or systemic diseases. 2. Weight of the resected prostate was markedly heavier in open surgery than TUR; the mean weight was 53.8 gm. for open surgery and 17.1 gm. for TUR. 3. Less amount of the operative blood loss in TUR was encountered than open surgery; the mean amount of blood loss per patient was 113.6 ml. for TUR and 437.0 ml. for open surgery. 4. Operation time was shorter in TUR than in open surgery; the mean time was 74.8 min. for TUR and 120.2 min. for open surgery. 5. Postoperative complications were significantly fewer in TUR than in open surgery. There seemed no relation between age and complication. In TUR incidence of complications was increased when the operation time was above 60 min. but no relation was found in open surgery between the operation time and complication. 6. Overall mortality rate for prostatectomy was 1.1% ; for TUR 1.0% and for open surgery 1.3%. 7. Duration of the postoperative catheterization was remarkably shorter in TUR than open surgery; the mean duration was 5.9 days for TUR and 10.5 days for open surgery. 8. Duration of the hospital stay was fairly shorter in TUR than in open surgery; the mean duration was 12.2 days for TUR and 18.4 days for open surgery.
Catheterization ; Catheters ; Humans ; Incidence ; Length of Stay ; Mortality ; Postoperative Complications ; Prostate ; Prostatectomy ; Prostatic Hyperplasia* ; Transurethral Resection of Prostate

PURPOSE: Apoptosis is a process of natural cell death that can occur under both normal and neoplastic conditions and increased apoptosis in neoplastic conditions is a feature of the increasing malignant potential. We investigated the possible relationship between the apoptotic index(AI) and Gleason grade, T stage of prostatic carcinoma. MATERIALS AND METHODS: A total of 31 patients with untreated prostatic carcinoma diagnosed by TURP, transrectal needle biopsy and radical prostatectomy was evaluated. We used in situ end labeling method for apoptotic staining. AI was compared with Gleason grade and T stage. RESULTS: The values of mean AI according to Gleason grade were grade I, 1.3+/- 0.13, II, 1.38+/-0.11, III, 1.92+/-0.20, IV, 2.0+/-0.20, V, 2.01 +/-0.28. A positive correlation was noted between apoptotic index and Gleason grade, but not between apoptotic index and T stage. CONCLUSIONS: We found a positive correlation between AI and Gleason grade and the possibility that AI may serve as an important morphological marker to predict the behavior of prostatic carcinoma.
Apoptosis ; Biopsy, Needle ; Cell Death ; Humans ; Prostate* ; Prostatectomy ; Prostatic Neoplasms ; Transurethral Resection of Prostate

Recently, laser treatment of benign prostatic hyperplasia (BPH) is considered as a promising alternative to traditional transurethral resection of the prostate (TURP). To evaluate the effectiveness and safety of laser therapy on BPH, we compared the results of transurethral balloon laser thermotherapy (TUBALT, n=13) and Hybrid laser prostatectomy (HLP, n=21) with those of TURP (n=25) in 58 patients with mild and moderate BPH. Following data were evaluated at postoperative 1, 3 and 6 months : AUA symptom score (SS), maximal flow rate (Qmax), subjective symptom improvement (SI), postoperative complications. All 3 groups show significant improvement after treatment in the Qmax values. Among 3 groups, the Qmax value was lower in TUBALT group (12.9+/-3.3 ml/sec) than those in HLP group (15.5+/-5.2 ml/sec) and TURP group (18.7+/-5.3 ml/sec) on postoperative 6 months. The Qmax values were not significantly different between HLP and TURP groups. In the SS values, all 3 groups show significant improvement after treatment and, TUBALT (9.9+/-9.7) and HLP (10.3+/-9.4) group were comparable to TURP group (5.2+/-4.2) on postoperative 6 months. In global assessment of SI, both HLP (87.5%) and TUBALT (75%) group were also comparable to TURP (90%) group on postoperative 3 months. but TUBALT group showed delayed symptom improvement compared to TURP group. Postoperative complications were minimal both in HLP and TUBALT groups, compared to TURP group. These results suggest that both HLP and TUBALT are effective in mild and moderate BPH, Further more, HLP treatment could be considered a promising alternative to TURP.
Humans ; Hyperthermia, Induced* ; Laser Therapy ; Postoperative Complications ; Prostate ; Prostatectomy* ; Prostatic Hyperplasia* ; Transurethral Resection of Prostate