TY - JOUR
T1 - Management of prostate enlargement with acute urinary retention
T2 - Diode laser vaporization in combination with bipolar transurethral resection of the prostate
AU - Tzou, Kai Yi
AU - Kao, Wei Tang
AU - Lan, Chi Yun
AU - Ho, Chen-Hsun
AU - Chiang, Yi Te
AU - Chen, Kuan Chou
N1 - Publisher Copyright:
© 2016.
PY - 2016/3/1
Y1 - 2016/3/1
N2 - Objective: Transurethral resection of prostate (TURP) has long been the gold standard for the management of benign prostate enlargement (BPE). Over the years, laser techniques have been developed as major alternative treatment for BPE. Retrospectively, we compared the preoperative status and surgical outcomes of conventional TURP with those of high-intensity diode laser vaporization in combination with bipolar TURP (DV + bTURP) in patients with BPE who are suffering from refractory acute urinary retention. Materials and methods: This is a retrospective chart review study. A total of 60 patients with BPE who were suffering from refractory acute urinary retention were enrolled between July 2011 and July 2013. Thirty-four patients were included in the TURP group and 26 in the DV + bTURP group. Perioperative parameters, including operation time, hemoglobin decrease, length of hospital stay, and time for catheter removal, were all recorded. Patients were followed postoperatively with peak flow rate measurement, international prostate symptom scores, and postvoid residual volume, and all adverse events were also recorded. Results: DV + bTURP was superior to TURP in terms of hospital stay (3.1 d vs. 4.2 d), catheter removal time (1.3 d vs. 3.2 d), hemoglobin reduction (0.8 g/dL vs. 2.5 g/dL), and fewer adverse events. However, it was inferior to TURP in terms of operation time (93.2 min vs. 68.5 min). Complications are also comparable. No significant differences were observed in peak flow rates, international prostate symptom score, and postvoid residual volume between the two procedures. Conclusion: DV + bTURP is comparable with monopolar TURP for relieving acute urinary retention in men with BPE in terms of complications and functional outcomes. The combined technique can provide better intraoperative hemostasis and shorter catheterization time, with no significant postoperative irritative symptoms.
AB - Objective: Transurethral resection of prostate (TURP) has long been the gold standard for the management of benign prostate enlargement (BPE). Over the years, laser techniques have been developed as major alternative treatment for BPE. Retrospectively, we compared the preoperative status and surgical outcomes of conventional TURP with those of high-intensity diode laser vaporization in combination with bipolar TURP (DV + bTURP) in patients with BPE who are suffering from refractory acute urinary retention. Materials and methods: This is a retrospective chart review study. A total of 60 patients with BPE who were suffering from refractory acute urinary retention were enrolled between July 2011 and July 2013. Thirty-four patients were included in the TURP group and 26 in the DV + bTURP group. Perioperative parameters, including operation time, hemoglobin decrease, length of hospital stay, and time for catheter removal, were all recorded. Patients were followed postoperatively with peak flow rate measurement, international prostate symptom scores, and postvoid residual volume, and all adverse events were also recorded. Results: DV + bTURP was superior to TURP in terms of hospital stay (3.1 d vs. 4.2 d), catheter removal time (1.3 d vs. 3.2 d), hemoglobin reduction (0.8 g/dL vs. 2.5 g/dL), and fewer adverse events. However, it was inferior to TURP in terms of operation time (93.2 min vs. 68.5 min). Complications are also comparable. No significant differences were observed in peak flow rates, international prostate symptom score, and postvoid residual volume between the two procedures. Conclusion: DV + bTURP is comparable with monopolar TURP for relieving acute urinary retention in men with BPE in terms of complications and functional outcomes. The combined technique can provide better intraoperative hemostasis and shorter catheterization time, with no significant postoperative irritative symptoms.
KW - Acute urinary retention
KW - Benign prostate enlargement
KW - Diode laser vaporization
KW - Transurethral resection of prostate
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U2 - 10.1016/j.urols.2015.12.002
DO - 10.1016/j.urols.2015.12.002
M3 - Article
AN - SCOPUS:84958259361
SN - 1879-5226
VL - 27
SP - 31
EP - 34
JO - Urological Science
JF - Urological Science
IS - 1
ER -