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Urology. 2010 Oct;76(4):958-61. doi: 10.1016/j.urology.2010.01.079. Epub 2010 Apr 15.

A randomized trial of transvesical prostatectomy versus transurethral resection of the prostate for prostate greater than 80 mL.

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  • 1Department of Urology, Guangzhou First Municipal People's Hospital, Guangzhou Medical College, Guangzhou, China.

Abstract

OBJECTIVES:

We compared the safety and efficacy of transvesical prostatectomy (TVP) and transurethral resection of the prostate (TURP) for prostate greater than 80 mL in a prospective randomized trial.

METHODS:

Eighty patients with urodynamic obstruction and prostate volume >80 mL were prospectively randomized and assigned to TVP or TURP. Patients were assessed preoperatively and followed up at 3 and 12 months postoperatively. International prostate symptom score (IPSS), quality of life score (QoLS), maximum flow rate (Q(max)(.)), and postvoid residual volume (PVR) were obtained at each follow-up. Perioperative data and postoperative outcomes were compared. All complications were recorded.

RESULTS:

Of 80 patients eligible to participate, 69 patients completed 12 months of follow-up. TURP procedure was not faster than TVP procedure (P = .41); 53.2% and 84.4% of prostatic tissue were resected after TURP and TVP, respectively (P < .001). In the TVP group, IPSS, Q(max)(.), QoLS, and PVR volume were significantly better than those in TURP group at 3 and 12 months of follow-up. At 12 months postoperatively, IPSS improved 87.6% and 62.3%, mean Q(max)(.) increased by 11.49 mL/s (230.2%) and 6.33 mL/s (102%), and mean PVR volume decreased by 71.2 mL (88.6%) and 65.4 mL (70.5%) in TVP and TURP group, respectively. Two TURP patients developed urethral stricture requiring reoperation.

CONCLUSIONS:

TVP may be more effective and safer than TURP for the benign prostatic hyperplasia patient whose prostate volume is >80 mL.

Copyright © 2010 Elsevier Inc. All rights reserved.

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PMID:
20394966
[PubMed - indexed for MEDLINE]
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