Complications following transurethral prostatectomy: An analysis of 14 cases / 中国微创外科杂志

ABSTRACT

Objective To study the etiology,prophylaxis,and management of complications after transurethral prostatectomy. Methods Clinical data of 73 patients with benigh prostatic hyperplasia(BPH) undergoing transurethral resection of prostate(TURP) or transurethral vaporization of prostate(TUVP) in this hospital from August 2002 to August 2005 were reviewed.Complications occurred in 14 patients,including severe bleeding in bladder in 2 patients,postoperative urinary retention in 5 patients,urethral stricture in 2 patients,urinary incontinence in 2 patients,TURP syndrome due to the perforation of the prostatic membrane in 2 patients,and lower-extremity deep venous thrombosis in 1 patient. Results A conversion to open surgery was required in 1 patient with severe bleeding in bladder and no re-bleeding happened.In another patient with severe bleeding in bladder,a trilumen single balloon catheter was intriduced into the bladder for continuous bladder irrigation with normal saline or iced normal saline,in association with medical therapy,to obtain a full recovery of voiding function without re-bleeding.Among 5 patients with urinary retention after operation,a re-operation of TURP was conducted in 2 patients and a dilatation of the urethra in association with oral symptomatic medication was carried out in 3 patient.No recurrence of urinary retention was noted and a re-examination of the maximum flow values(Qmax) at 1~3 months after operation revealed more than 15 ml/s.The voiding function recovered well in 2 patients with urethral stricture after periodic dilatation of the urethra.Permanent cystostomy was performed in 2 patients with urinary incontinence.In 2 patients with TURP syndrome,the operation was terminated immediately and active symptomatic treatment was conducted.The two patients experienced stable vital signs and a good recovery of voiding function.The patient with lower-extremity deep venous thrombosis was cured 2 weeks later. Conclusions Urinary retention and urethral stricture are common complications following transurethral resection of prostate.Careful selection of patients,strict adherence to technique,and timely and proper management of complications are considered essential to improve results.