In a nutshell
This study compared the rate of complications after 3 surgical procedures to treat benign prostatic hyperplasia (BPH). Researchers reported the lowest rate of encounters between patients and medical staff after transurethral resection of the prostate (TURP), the standard of care, compared to two laser surgeries.
Some background
Transurethral resection of the prostate (TURP) is the most common surgery used for treating BPH-related urinary symptoms. It involves the destruction of prostate tissue through a wire loop inserted into the urethra (the penile opening). Removing enlarged tissue from the prostate allows for better flow through the urethra and relieves symptoms of BPH.
More recently developed surgical procedures include GreenLight photoselective vaporization (PVP) and holmium laser enucleation of the prostate (HoLEP). Both techniques are minimally invasive and use high-intensity lasers to vaporize enlarged prostate tissue. PVP and HoLEP are both associated with good safety and effectiveness. However, more studies are needed to examine the rate of complications after BPH procedures.
Methods & findings
This study aimed to compare the number of encounters patients had with medical staff after TURP, PVP, and HoLEP.
The records of 291 men treated with a surgical procedure for BPH were analyzed. 68.4% of men underwent TURP. 20.6% of men were treated with HoLEP. 11% of men underwent PVP. The number of encounters the patients had with medical staff after the procedure were followed for up to 6 months.
The number of encounters 30 days after the procedure was significantly lower for TURP compared to PVP and HoLEP. 48.7% of patients treated with TURP had at least one encounter with medical staff 30 days after being discharged. In contrast, 66.7% of men treated with HoLEP and 93.7% of men treated with PVP had one encounter or more within 30 days.
The number of encounters within 90 days after discharge was also significantly lower following TURP. Within 6 months after being discharged, 81.4% of patients treated with TURP had at least one encounter with medical staff. This was significantly lower compared to HoLEP (88.3%) and PVP (96.9%).
Overall, HoLEP was associated with the greatest improvement in urine stream flow. TURP was associated with the greatest improvement in complete bladder emptying. The duration of catheterization (flexible tube inserted into the bladder to drain urine) was more favorable with HoLEP and TURP. The shortest length of hospital stay and smallest change in red blood cell counts was observed with PVP.
The bottom line
Researchers concluded that TURP was associated with the fewer encounters with medical staff after the procedure compared to HoLEP and PVP.
The fine print
Larger studies that randomly assign patients to a treatment group are needed to confirm these findings.
Published By :
Urology
Date :
Oct 19, 2016
