Transurethral resection syndrome during transurethral vaporization of the prostate: Report of 27 cases / 中国微创外科杂志

Objective To summarize the causes, diagnosis and treatment of transurethral resection syndrome (TURS) during the transurethral vaporization of the prostate (TUVP). Methods Among 322 consecutive patients who underwent TUVP, TURS happened in 27 patients (8.4%). Their clinical data on the operation, monitoring and treatment were retrospectively reviewed. Results Of the 27 patients, the mean operative time was 95 min (52~170 min), the mean blood loss was 251 ml (100~700 ml), and the mean weight of resected prostate was 36.1 g (16~82 g). During the operation the prostatic capsule was perforated in 21 patients (78%). Postoperatively, all the patients had yawning, hypotension and bradycardia. Their serum sodium concentrations during TURS were 122.3?9.6 mmol/L, which was 16.3?4.5 mmol/L lower than before the operation, with significant difference ( t=)14.211,P90 min). Close attention and assessment of the patient’s) vital signs and mental status can increase the early detection and treatment of TURS.

Combined use of transurethral vaporization and resection for benign prostatic hyperplasia: Clinical study of 122 cases / 中国微创外科杂志

Objective To summarize the effect of transurethral vaporization of the prostate (TUVP) in combination with transurethral resection of the prostate (TURP) for the treatment of benign prostatic hyperplasia (BPH). Methods A combined use of TUVP and TURP was carried out for treating 122 cases of BPH. There were 8 cases of Rous stage Ⅰ disease, 58 cases of stage Ⅱ, 32 cases of stage Ⅲ, and 24 cases of Ⅳ. Results The length of duration of the operation was 20~140 min (mean, 68 min). The intraoperative blood loss was 40~200 ml (mean, 80 ml). A blood transfusion of 200 ml was required in 2 cases after the operation. No transurethral resection syndrome (TURS) occurred. The mean postoperative catheterization time was 6 days. All 122 patients had been followed for 4~19 months (mean, 10 months). The international prostate symptom score (IPSS) decreased from 30.2?2.3 pre-)operation to 10.8?2.5 post-operation (t=10.84,P=0.000); the residual urine (RU) decreased from 252.6?65.3 ml pre-operation to 35.6?10.4 ml post-operation (t=23.52,P=0.000); the maximum urinary flow rate (Qmax) increased from 8.5?2.8 ml/s to 20.6?3.8 ml/s (t=6.67,P=0.000). Postoperatively, transient urinary incontinence was observed in 2 cases, and anterior urethral stricture occurred in 2 cases. Conclusions Combined use of transurethral electrovaporization and resection of the prostate for the treatment of BPH gives satisfactory effects.

Transurethral vaporization of the prostate with prying-up technique in the treatment of benign prostatic hyperplasia in elderly patients / 中国微创外科杂志

Objective To explore a new and effective minimally invasive procedure in the management of benign prostatic hyperplasia (BPH) in senile patients. Methods Transurethral vaporization of the prostate (TUVP) with prying-up technique was performed in 68 patients above the age of 80 with BPH. Results The mean procedure duration was 60 min, and the mean weight of resected prostate was 37.6 g. The mean intraoperative blood loss was 65 ml, and the mean hospital stay, 6 days. Postoperative ~follow-up for 0.5~2 years showed the international prostate symptom score (IPSS) decreased from 23.5?4.2 to 6.5?2.1, the quality of life index (QOL) was reduced from 4.6?0.6 to 2.2?0.2, the maximum flow rate (Qmax) elevated from 8.7?4.3 ml/s to 18.0?2.2 ml/s, and the residual urine (RU) dropped from 176.0?86.7 ml to 12.2?2.4 ml. As compared with preoperative values, all the parameters were significantly improved 6 months after the procedure (P