Comparison of Transurethral Resection of Prostate Plus Incision of Bladder Neck and Prostate with Transurethral Resection of Prostate in Patients with Benign Prostatic Hyperplasia / 대한남성과학회지

ABSTRACT

PURPOSE: We evaluated the effectiveness and complications of transurethral resection of the prostate plus incision of the bladder neck and prostate(TUR-P+I) and transurethral resection of the prostate(TUR-P). MATERIALS AND METHODS: We reviewed 101 patients with benign prostatic hyperplasia(BPH) who were randomized to TUR-P+I(N=78; Group I) or TUR-P(N=23; Group II) from December 2000 to March 2002. After TUR of the adenoma, the trigone, bladder neck, and surgical capsule of the prostate were incised with a pointed coagulating electrode at the 5- and 7-o'clock positions from the distal edge of the ureteral orifice to the verumontanum. Patients were evaluated at 1 month, 3 months, and 6 months after operation in terms of the change in International Prostatic Symptom Score(IPSS), peak urinary flow rate, and complications. RESULTS: The mean prostatic weight of Groups I and II was 40.5+/-15.5 g and 36.7+/-10.6 g, respectively. The operative time and resected prostatic weight of Group I were 59.0+/-23.8 min and 16.2+/-11.4 g and those of Group II were 64.1+/-27.5 min and 11.5+/-5.8 g. The postoperative complication rates were similar in the two groups. The preoperative IPSS symptom score and peak urinary flow rate were 22.4+/-6.4 and 9.8+/-5.4 mL/sec, respectively, in Group I and 23.7+/-7.6 and 9.3+/-4.4 mL/sec in Group II. The 1-, 3-, and 6-month IPSS were 13.2+/-6.0, 10.1+/-5.1, and 9.2+/-4.8 in Group I and 13.2+/-5.0, 10.1+/-4.2, and 9.2+/-4.4 in Group II. The peak urinary flow rates at those times were 15.6+/-4.9, 15.8+/-5.6, and 15.9+/-5.1 mL/sec in Group I and 14.6+/-4.2, 14.6+/-3.9, and 14.3+/-4.5 mL/sec in Group II. CONCLUSIONS: The TUR-P+I could be a safe, effective surgical method for BPH. However, longer follow-up and more patients are required to establish the value of this technique.