, Volume 6, Issue 4, pp 241-249
Date: 23 Sep 2011

Management of the Failed Transurethral Resection of the Prostate

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Abstract

Transurethral resection of the prostate (TURP) is the gold standard for treatment of symptomatic benign prostatic enlargement. Failure of TURP and other similar procedures may occur when a patient has poor bladder emptying postoperatively or has persistent or de novo bothersome postoperative lower urinary tract symptoms. Reasons for failure include inadequate resection, clot retention, anesthesia-related side effects, postoperative pain, hypo- or acontractile bladder, and/or poor patient selection. Patients initially can be managed conservatively or proactively. When clinically significant storage or voiding dysfunction persists, evaluation is necessary and may include cystoscopy and/or urodynamics. Depending on the diagnosis and etiology, patients can then be managed with an array of therapies, including urethral catheterization, oral medications, intravesical botulinum A toxin, neuromodulation, or further surgery as indicated.