Transurethral resection of the prostate with monopolar resectoscope: single-surgeon experience and long-term results of after 3589 procedures

Objective: 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.

Methods: 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.

Results: 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.

Conclusion: 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.