Complications of Transurethral Resection of the Prostate (TURP)--Incidence, Management, and Prevention

@article{citeulike:1535966, abstract = {Objectives To update the complications of transurethral resection of the prostate (TURP), including management and prevention based on technological evolution.Methods Based on a MEDLINE search from 1989 to 2005, the 2003 results of quality management of Baden-Wurttemberg, and long-term personal experience at three German centers, the incidence of complications after TURP was analyzed for three subsequent periods: early (1979-1994); intermediate (1994-1999); and recent (2000-2005) with recommendations for management and prevention.Results Technological improvements such as microprocessor-controlled units, better armamentarium such as video TUR, and training helped to reduce perioperative complications (recent vs. early) such as transfusion rate (0.4\% vs. 7.1\%), TUR syndrome (0.0\% vs. 1.1\%), clot retention (2\% vs. 5\%), and urinary tract infection (1.7\% vs. 8.2\%). Urinary retention (3\% vs. 9\%) is generally attributed to primary detrusor failure rather than to incomplete resection. Early urge incontinence occurs in up to 30-40\% of patients; however, late iatrogenic stress incontinence is rare (<0.5\%). Despite an increasing age (55\% of patients are older than 70), the associated morbidity of TURP maintained at a low level (<1\%) with a mortality rate of 0-0.25\%. The major late complications are urethral strictures (2.2-9.8\%) and bladder neck contractures (0.3-9.2\%). The retreatment rate range is 3-14.5\% after five years.Conclusions TURP still represents the gold standard for managing benign prostatic hyperplasia with decreasing complication rates. Technological alternatives such as bipolar and laser treatments may further minimize the risks of this technically difficult procedure.}, author = {Rassweiler, Jens and Teber, Dogu and Kuntz, Rainer and Hofmann, Rainer }, booktitle = {European Urology goes Platinum}, citeulike-article-id = {1535966}, doi = {10.1016/j.eururo.2005.12.042}, journal = {European Urology}, keywords = {basic, complications, fulltxt, review, turp}, month = {November}, number = {5}, pages = {969--980}, posted-at = {2007-08-05 07:04:09}, priority = {2}, title = {Complications of Transurethral Resection of the Prostate (TURP)--Incidence, Management, and Prevention}, url = {http://dx.doi.org/10.1016/j.eururo.2005.12.042}, volume = {50}, year = {2006} }

TY - JOUR ID - citeulike:1535966 L3 - citeulike-article-id:1535966 TI - Complications of Transurethral Resection of the Prostate (TURP)--Incidence, Management, and Prevention T2 - European Urology goes Platinum JF - European Urology VL - 50 IS - 5 SP - 969 EP - 980 N2 - Objectives To update the complications of transurethral resection of the prostate (TURP), including management and prevention based on technological evolution.Methods Based on a MEDLINE search from 1989 to 2005, the 2003 results of quality management of Baden-Wurttemberg, and long-term personal experience at three German centers, the incidence of complications after TURP was analyzed for three subsequent periods: early (1979-1994); intermediate (1994-1999); and recent (2000-2005) with recommendations for management and prevention.Results Technological improvements such as microprocessor-controlled units, better armamentarium such as video TUR, and training helped to reduce perioperative complications (recent vs. early) such as transfusion rate (0.4% vs. 7.1%), TUR syndrome (0.0% vs. 1.1%), clot retention (2% vs. 5%), and urinary tract infection (1.7% vs. 8.2%). Urinary retention (3% vs. 9%) is generally attributed to primary detrusor failure rather than to incomplete resection. Early urge incontinence occurs in up to 30-40% of patients; however, late iatrogenic stress incontinence is rare (<0.5%). Despite an increasing age (55% of patients are older than 70), the associated morbidity of TURP maintained at a low level (<1%) with a mortality rate of 0-0.25%. The major late complications are urethral strictures (2.2-9.8%) and bladder neck contractures (0.3-9.2%). The retreatment rate range is 3-14.5% after five years.Conclusions TURP still represents the gold standard for managing benign prostatic hyperplasia with decreasing complication rates. Technological alternatives such as bipolar and laser treatments may further minimize the risks of this technically difficult procedure. KW - basic KW - complications KW - fulltxt KW - review KW - turp AU - Rassweiler, Jens AU - Teber, Dogu AU - Kuntz, Rainer AU - Hofmann, Rainer PY - 2006/11// UR - http://dx.doi.org/10.1016/j.eururo.2005.12.042 ER -