The Efficacy of Bipolar Transurethral Resection of the Prostate in Patients with Large Prostates(>80g) and Analysis of the Postoperative Results Based on the Resection Ratio / 대한비뇨기과학회지

ABSTRACT

PURPOSE: We evaluated the efficacy of bipolar transurethral resection of the prostate(TURP) in patients with large prostates(>80g) and determined the postoperative results based on the transitional zone resection ratio. MATERIALS AND METHODS: Thirty patients with benign prostatic hyperplasia (BPH)>80g(group 1) and 76 patients with BPH between 30g and 80g (group 2) were evaluated. The evaluation before TURP included the International Prostate Symptom Score(IPSS), maximum urinary flow rate (Qmax), post-void residual urine(PVR), and transrectal ultrasonography. The operative time, weight of resected tissue, change in serum hemoglobin, and complications were noted. After TURP, patients were reassessed for the IPSS, Qmax, and PVR at 6 months. In group 1, subgroup analysis of the postoperative symptom scores was performed based on the ratio of the resection volume(RV) to the transitional zone volume(TZV). RESULTS: In patients with large prostates, the operative times were prolonged, and the weights of resected tissues were higher. However, there were no statistically significant differences between the two groups with respect to hemoglobin changes, postoperative hospital stays, or complications. The postoperative clinical parameters were markedly improved in both groups. Severe bleeding necessitated blood transfusion, and the TURP syndrome did not occur in any patients. The symptom score improved more as the RV/TZV increased. CONCLUSIONS: Bipolar TURP is an effective and safe surgical treatment method, even in patients with large prostates. Considering that the complications associated with bipolar TURP are very rare, surgeons should aim to perform a complete resection of the enlarged transitional zone to ensure a good postoperative result.