The Effects and Complications of Transurethral Resection for Benign Prostatic Hyperplasia : Results of Long-term Follow-up / 대한비뇨기과학회지

ABSTRACT

To evaluate the long-term effect and complications of the transurethral resection of the prostate (TUR-P), we analyzed its results of 404 patients who were followed properly out of 827 patients who underwent TUR-P at Seoul National University Hospital from January 1980 to December 1993. Various pre-existing medical problems were associated in 173 patients(42.8%). The mean weight of the resected tissue was 15.6 grams and the mean operation time was 78.9 minutes with the resection amount per minute of 0.2 gm/min. Improvement of the symptoms was reported in 304 patients(75.2%) postoperatively. International prostate symptom score(IPSS) was 22.6 preoperatively, 15.4 at 3 months, 9.8 at one year and 9.3 at 3 years after TUR-P Maximum urinary flow rate(MFR) was 9.7 ml/sec preoperatively, 15.5 at 3 months and 15.9 at one year after TUR- P The perioperative mortality rate was 0.4%, and the perioperative complications occurred in 120 patients(29.7%); including 15.8% of bleeding and 2.2% of the transurethral resection syndrome. The morbidity increased significantly with the increasing resection amount and the operation time. But not only age but also pre-existing cardiopulmonary diseases and azotemia did not influence the morbidity. Only age over 80 and preoperative urinary tract infection increased the perioperative morbidity slightly. Late complication developed in 54 patients(13.4%); urinary tract infection in 18 (4.5%), urethral stricture in 16 (4.0%), impotence in 9 (2.2%), urinary in- continence in 5 (1.2%), bladder neck contracture in 4 (1.0%) and bleeding in 2 (0.5%). Persistent voiding difficulties were reported in 100 patients(25.7%), causes were neurogenic bladder in 32, inappropriate indication of TUR-P in 32, and incomplete resection in 18 patients and so on. Repeated TUR-P was done in 16(4.0%) patients.