Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey.
Urology. 2011 Nov;78(5):1151-5. doi: 10.1016/j.urology.2011.04.072. Epub 2011 Sep 3.
To present our clinical outcomes and to assess the impact of technological improvements that have occurred recently in transurethral resection of the prostate (TURP) on its morbidity.
The data from the 3589 patients who underwent conventional monopolar TURP for BPH from March 2000 to December 2008 were evaluated retrospectively. Data were analyzed to obtain perioperative and postoperative complications, operative time, weight of prostate chips resected, time to catheter removal, and hospitalization time. Patients were followed at 3 months and then yearly. The follow-up included the International Prostate Symptom Score (IPSS), quality of life score (QoL), maximum urinary flow rate (Q(max.)), and prostate-specific antigen. The significant improvements in mean the IPSS, QoL score, and Q(max.) were observed in postoperative visits.
Intraoperative perforation of prostatic capsule or bladder neck was observed in 27 (0.75%) patients. In the early postoperative period, clot retention with secondary bleeding was observed in 81 (2.3%) patients. Recatheterization was required in 195 (5.4%) patients. Mild to moderate dysuria was observed in 819 (23%) patients. Urinary tract infection occurred in 234 (6.5%) cases. Severe dysuria, urgency, and urge incontinence was observed in 93 (2.6%) patients in the first week after surgery. During the follow-up period, urethral stricture and bladder neck contracture occurred in 117 (3.2%) and 39 (1.08%) patients, respectively. There was no the iatrogenic incontinence. Re-operation as a result of rest prostatic adenoma was required in 158 (4.4%) patients.
These data demonstrate that a technical improvement in TURP provides a lower complication rate. Conventional monopolar TURP can now be performed with excellent long-term efficacy combined with reduced complications.
介绍我们的临床结果，并评估最近经尿道前列腺切除术（TURP）技术改进对其发病率的影响。
回顾性分析 2000 年 3 月至 2008 年 12 月期间 3589 例行传统单极 TURP 治疗 BPH 的患者数据。分析数据以获得围手术期和术后并发症、手术时间、切除的前列腺芯片重量、导尿管拔除时间和住院时间。患者在术后 3 个月和每年进行随访。随访包括国际前列腺症状评分（IPSS）、生活质量评分（QoL）、最大尿流率（Q(max.)）和前列腺特异性抗原。术后随访时观察到 IPSS、QoL 评分和 Q(max.) 的平均显著改善。
术中观察到 27 例（0.75%）患者前列腺包膜或膀胱颈穿孔。术后早期，81 例（2.3%）患者出现血块滞留伴继发性出血。195 例（5.4%）患者需要重新导尿。819 例（23%）患者出现轻度至中度排尿困难。234 例（6.5%）患者发生尿路感染。93 例（2.6%）患者在术后第一周出现严重排尿困难、尿急和急迫性尿失禁。随访期间，117 例（3.2%）和 39 例（1.08%）患者分别发生尿道狭窄和膀胱颈挛缩。无医源性尿失禁。158 例（4.4%）患者因残余前列腺腺瘤需要再次手术。
这些数据表明 TURP 技术的改进可降低并发症发生率。传统单极 TURP 现在可以结合减少并发症，实现出色的长期疗效。
