Transurethral resection of the prostate: fate of the non-responders
DOI:
https://doi.org/10.1080/21681805.2020.1812712Abstract
Abstract Background Transurethral resection of the prostate (TURP) has been the standard method of surgical management of benign prostatic enlargement for decades. Some patients experience significant voiding dysfunction and discomfort postoperatively, without any apparent clinical complications from the procedure. Furthermore, a significant proportion of men still require postoperative catheterisation. This study analysed patients defined as non-responders after TURP with the principal aim to reveal their fate. Methods A prospectively recruited cohort of 355 men, who underwent TURP during 2010–2012, was investigated. Non-responders were identified as still requiring catheterisation postoperatively and/or exhibiting all of the following voiding outcomes based on the de Wildt criteria: IPSS > 7, bother score > 2, Qmax 100 mL. The non-responders were followed for a maximum period of three years using retrospective chart reviews. Results Thirty-five men were defined as non-responders. Of these, 26 men were operated on due to urinary retention and nine men due to bothersome symptoms. The non-responders were followed for a mean time of 72 months. Seven men underwent a redo-TURP and two men a bladder neck incision. Eleven of the 35 men were finally judged as having satisfactory voiding parameters. Sixteen men used CISC. Eleven men reduced the frequency of CISC to a minimum. Seven men had to use an indwelling catheter indefinitely. Conclusion Men with preoperative urinary retention constituted the vast majority of non-responders. The use of postoperative urodynamic studies was remarkably low. Almost one in three non-responders finally had a satisfactory outcome with or without re-intervention.Downloads
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Acta Chirurgica Scandinavica Society owns the copyright for all material published until Volume 57 (2023) unless otherwise specified. As from Volume 59 (2024) all published articles, unless otherwise specified, are published under CC-BY licences, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, with the condition of proper attribution to the original work.