ABSTRACT
Objectives:
Surgical treatment is indicated in patients where medical therapy fails to prove beneficial or in patients who develop complications related with bladder outlet obstruction. In our study, we developed a new surgical technique which can be defined as Transvesical Resection of Prostate (TVRP) without using the urethra. This method was previously described in our articles (1).
Materials and Methods:
A 62-years-old male patient, using an alpha blocker agent for 5 years, reported increased discomfort with urination. His findings were as follows: PSA: 1.2 ng/dL, prostate volume: 45 cc, digital rectal examination: benign, IPSS: 30, QoL: 5, Qmax: 6, urine volume: 225 cc, post-mictional residue: 65 cc. Eventually the patient was informed and prostate resection decision was made.
Results:
Suprapubic catheter was removed 1 day after surgery and the patient was discharged. Urethral catheter was removed 4 days after urine output became clear. No complications developed after the operation. At postoperative 1st month, Qmax was 22, urine volume was 260 cc, post-mictional residue was 40 cc, IPSS was 8, QoL was 1, and the pathology was benign prostate tissue.
Conclusions:
Urethral stricture is one of the most important postoperative complications of TURP. The incidence of urethral stricture is reported between 2.2% and 9.8% in different series (2–5). In this technique which we developed, urethra is not used and prostate is removed through the bladder, similar to open prostatectomies. For this reason, we suggest that it has an advantage over TURP, regarding urethral stricture development.
ARTICLE INFO
Available at: http://www.intbrazjurol.com.br/video-section/20180488_Turk_et_al
Int Braz J Urol. 2019; 45 (Video #X): 1279-80
ACKNOWLEDGMENT
The authors thank to Zorlu Ferruh, MD for his contributions to this work.
Footnotes
ETHICS COMMITTEE APPROVAL
The Institutional Review Board approved this study
REFERENCES
- 1.Türk H, Ün S, Arslan E. A new surgical technique: transvesical resection of prostate - case series. Int Braz J Urol. 2018;44:1023–1031. doi: 10.1590/S1677-5538.IBJU.2018.0113. [DOI] [PMC free article] [PubMed] [Google Scholar]; 1. Türk H, Ün S, Arslan E. A new surgical technique: transvesical resection of prostate - case series. Int Braz J Urol. 2018;44:1023-31. [DOI] [PMC free article] [PubMed]
- 2.Kuntz RM, Ahyai S, Lehrich K, Fayad A. Transurethral holmium laser enucleation of the prostate versus transurethral electrocautery resection of the prostate: a randomized prospective trial in 200 patients. J Urol. 2004;172:1012–1016. doi: 10.1097/01.ju.0000136218.11998.9e. [DOI] [PubMed] [Google Scholar]; 2. Kuntz RM, Ahyai S, Lehrich K, Fayad A. Transurethral holmium laser enucleation of the prostate versus transurethral electrocautery resection of the prostate: a randomized prospective trial in 200 patients. J Urol. 2004;172:1012-6. [DOI] [PubMed]
- 3.Armaǧan A, Soyupek S, Hoşcan M, Perk H, Serel A. Comparison of the efficacy of internal urethrotomy and benique dilations in the management of recurrent anterior and posterior urethral strictures. Turk J Urol. 2006;32:404–410. [Google Scholar]; 3. Armaǧan A, Soyupek S, Hoşcan M, Perk H, Serel A. Comparison of the efficacy of internal urethrotomy and benique dilations in the management of recurrent anterior and posterior urethral strictures. Turk J Urol 2006;32:404-10.
- 4.de la Rosette JJ, Alivizatos G, Madersbacher S, Perachino M, Thomas D, Desgrandchamps F, de Wildt M, European Association of Urology EAU Guidelines on benign prostatic hyperplasia (BPH) Eur Urol. 2001;40:256–263. doi: 10.1159/000049784. discussion 264. [DOI] [PubMed] [Google Scholar]; 4. de la Rosette JJ, Alivizatos G, Madersbacher S, Perachino M, Thomas D, Desgrandchamps F, de Wildt M; European Association of Urology. EAU Guidelines on benign prostatic hyperplasia (BPH). Eur Urol. 2001;40:256-63; discussion 264. [DOI] [PubMed]
- 5.Atalay A, Küçükpolat S, Tokta G, Ünlüer E, Koçan H, Coşkun E. Comparison of transurethral resection (TURP) and transurethral plasmavapourasation (TUVAP) of prostate in benign prostatic hypertrophy patients by using Plasmakinetic tissue treatment systems. Turkish Journal of Urology. 2007;33:308–316. [Google Scholar]; 5. Atalay A, Küçükpolat S, Tokta G, Ünlüer E, Koçan H, Coşkun E. Comparison of transurethral resection (TURP) and transurethral plasmavapourasation (TUVAP) of prostate in benign prostatic hypertrophy patients by using Plasmakinetic tissue treatment systems. Turkish Journal of Urology. 2007;33:308-16