Clinical observation of transurethral prostatectomy / 대한비뇨기과학회지

A clinical observation was made on the 204 consecutive patients who had underwent transurethral resection of the prostate(TURP) between Jan. 1987 and Dec. 1992 focusing on uroflowmetry and complications. The uroflowmetries using flow rate nomogram were performed on 75 patients preoperatively and postoperatively. The preoperative maximum flow rats was 9.6+/-4.9 ml/sec(-2.5 SD) and postoperative maximum flow rate was 18.1+/-8.7 ml/sec (-1.0 SD). Uroflowmetry was convenient and helpful to evaluate the results after TURP. Early complications were voiding difficulty(7.8%), delayed bleeding(4.4%), bleeding requiring transurethral fulguration(2.0%), TUR syndrome(2.0%) and epididymitis(1.0%). The early postoperative morbidity was 16.2% and risk factors for early morbidity were resection time longer than 90 minutes, age more than 80 years. associated neurogenic bladder and prostatic cancer on biopsy. Delayed complications were urethral stricture(3.5%), urinary incontinence(2.0%), and obstruction requiring re-TURP(1.5%). Delayed morbidity was 6.9% and the only risk factor for delayed morbidity was resection time longer than 90 minutes. Careful attention to risk factors and surgical details is needed to reduce the amountand significance of the postoperative morbidity.

The post-TURP change of the serum electrolyte and osmolarity by preoperative administration of furosemide / 대한비뇨기과학회지

To see the effectiveness of preoperatively administered furosemide for preventing Hypo-osmolarity and hyponatremia during TURP, 30 patients undergoing TURP were followed every preoperatively, 30 min intra-operatively as well as immediate postoperatively, 6 hours and 24 hours postoperatively with measurements of serum sodium, serum potassium and serum osmolarity. Among the 30 patients, 15 patients (experimental group) were administered furosemide immediately before TURP, the other 15 patients (control group) were not administered. We compared the changes of serum sodium, serum potassium and osmolarity of experimental group with those of control group. The result showed that the serum sodium and serum osmolarity were decreased significantly (p<0.01) in control group, but were not decreased significantly in experimental group. Thus, the preoperatively administered furosemide may prevent the dilutional hyponatremia and hypo-osmolarity during TURP, and may be helpful in high risk patient such as congestive heart failure and poor renal function.