Is there a difference in the peri-operative morbidity between patients undergoing transurethral resection of the prostate alone compared with patients undergoing transurethral resection combined with treatment of bladder stones?

ABSTRACT

To compare the peri-operative morbidity in patients undergoing transurethral resection of the prostate [TURF] for obstructing benign prostatic hyperplasia [BPH] alone with patients undergoing optical cystolitholapaxy for the treatment of moderately sized bladder calculi followed by TURF for obstructing BPH. Over a 10-year period, 25 patients with obstructing BPH associated with moderately sized bladder stones underwent optical cystolitholapaxy aiming at total stone clearance followed by TURP under the same anesthesia. They were retrospectively compared with a second group of 25 randomly selected patients matched for age and prostate size who had undergone TURF only. The parameters studied were the duration of surgery, the need for post-operative urethral catheterization / irrigation, post-operative hospitalization and post-operative morbidity. Complete stone clearance was achieved in all patients before the performance of TURF. In the study group the operative time was 47 +/- 21 minutes longer than in the control patients who had TURF alone. None of the patients required catheterization or post-operative bladder irrigation. There was no difference between the groups regarding the duration of post-operative hospitalization. A single case of lower urinary tract infection occurred in each group; it resolved with appropriate antibiotic treatment. None of the patients had associated fever, and mortality was nil. The combination of optical cystolitholapaxy with TURF under the same anesthesia in patients with small and moderately sized bladder calculi associated with obstructing BPH did not lead to any significant increase in peri-operative morbidity when compared with patients who underwent TURF only