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The state of TURP through a historical lens

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Abstract

In 1926 Maximilian Stern introduced a new instrument to treat obstructions at the vesical orifice and baptized it resectoscope. With reference to astonishing historical statements about the new instrument and surgical technique made by the pioneers and their critics we will value why transurethral resection of the prostate (TURP) remains the gold standard for most men suffering from lower urinary tract symptoms (LUTS) due to benign prostatic enlargement. TURP is currently challenged by recently introduced new instruments and techniques claiming advantages over TURP. However, TURP offers an excellent balance between high efficacy in symptom relieve and low morbidity along with low costs and favorable long term outcome compared to other treatment options. We will outline these arguments demonstrating that even after a century has elapsed, since its introduction into the urologists armamentarium, TURP continues to stand the passage of time.

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Fig. 1

(with permission from The William P. Didusch Center for Urologic History, American Urological Association)

Fig. 2

(with permission from The William P. Didusch Center for Urologic History, American Urological Association)

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References

  1. Stern M (1926) Resection of obstructions at the vesical orifice. JAMA 87(14):1726–1730

    Article  Google Scholar 

  2. Davis TM (1931) Prostate operation. Prospects of the patient with prostatic disease in prostatectomy vs resection. JAMA 97(19):1674–1679

    Article  Google Scholar 

  3. McCarthy A (1931) A new apparatus for endoscopic plastic surgery of the prostate, diathermia and excision of vesical growths. J Urol 26(5):695–696

    Article  Google Scholar 

  4. Martin HW, Day RV, Kutzmann AA (1932) Cysto-urethroscopic resection of the prostate. Cal West Med 36(2):76–79

    CAS  PubMed  PubMed Central  Google Scholar 

  5. EAU Guidelines (2020) Edn presented at the EAU Annual Congress Amsterdam 2020. ISBN 978-94-92671-07-3. https://uroweb.org/guideline/treatment-of-non-neurogenic-mal-luts. Accessed 14 Sept 2020

  6. Parsons JK, Barry MJ, Dahm P, Gandhi MC, Kaplan SA, Kohler TS, Lerner LB, Roehrborn CG, Stoffel JT, Welliver C, Wilt TJ, McVary KT (2020) Surgical Management of lower urinary tract symptoms attributed to benign prostatic hyperplasia: AUA guideline. http://www.auanet.org/guidelines/benign-prostatic-hyperplasia-(bph)-guideline. Accessed 14 Sept 2020

  7. Gilfrich C, Leicht H, Fahlenbrach C, Jeschke E, Popken G, Stolzenburg JU, Weissbach L, Zastrow C, Günster C (2016) Morbidity and mortality after surgery for lower urinary tract symptoms: a study of 95577 cases from a nationwide German health insurance database. Prostate Cancer Prostatic Dis 19(4):406–411

    Article  CAS  Google Scholar 

  8. Matta R, Dvorani E, Wallis C, Hird A, LaBossiere J, Kulkarni G, Kodama R, Carr L, Radomski SB, Saskin R, Herschorn S, Nam RK (2019) Complications after surgery for benign prostatic enlargement: a population-based cohort study in Ontario, Canada. BMJ Open 9(12):e032170. https://doi.org/10.1136/bmjopen-2019-032170

    Article  PubMed  PubMed Central  Google Scholar 

  9. Chughtai BI, Simma-Chiang V, Lee R, Isaacs A, Te AE, Kaplan SA, Sedrakyan A (2015) Trends and utilization of laser prostatectomy in ambulatory surgical procedures for the treatment of benign prostatic hyperplasia in New York State (2000–2011). J Endourol 29(6):700–706

    Article  Google Scholar 

  10. Izard J, Nickel JC (2011) Impact of medical therapy on transurethral resection of the prostate: two decades of change. BJU Int 108(1):89–93

    Article  Google Scholar 

  11. Young MJ, Elmussareh M, Morrison T, Wilson JR (2018) The changing practice of transurethral resection of the prostate. Ann R Coll Surg Engl 100(4):326–329

    Article  CAS  Google Scholar 

  12. Ingimarsson JP, Isaksson HJ, Sigbjarnarson HP, Gudmundsson J, Geirsson G (2014) Increased population use of medications for male lower urinary tract symptoms/benign prostatic hyperplasia correlates with changes in indications for transurethral resection of prostate. Scand J Urol 48(1):73–78

    Article  CAS  Google Scholar 

  13. Doyle RW, Feggetter GY (1935) Endoscopic resection of the prostate. BMJ 26(1):147–151

    Article  Google Scholar 

  14. Botto H, Lebret T, Barré P, Orsoni JL, Hervé JM, Lugagne PM (2001) Electrovaporization of the prostate with the Gyrus device. J Endourol 15(3):313–316

    Article  CAS  Google Scholar 

  15. Yang S, Lin WC, Chang HK, Hsu JM, Lin WR, Chow YC, Tsai WK, Lee TA, Lo KY, Chow K, Chen M (2004) Gyrus plasmasect: is it better than monopolar transurethral resection of prostate? Urol Int 73(3):258–261

    Article  Google Scholar 

  16. Alexander CE, Scullion MMF, Omar MI, Yuan Y, Mamoulakis C, N’Dow JMO, Chen C, Lam TBL (2020) Bipolar vs monopolar transurethral resection of the prostate for lower urinary tract symptoms secondary to benign prostatic obstruction: a Cochrane review. Can Urol Assoc J. https://doi.org/10.5489/cuaj.6464 (online ahead of print)

    Article  PubMed  PubMed Central  Google Scholar 

  17. Fechner G, Schaupp J, Hauser S, Müller SC. Educating transurethral electroresection of the prostate is safe and efficient: is training a risk factor for patients and hospitals? Urologe A 51(11):1572–1575

  18. Furuya S, Furuya R, Ogura H, Araki T, Arita T (2006) A study of 4031 patients of transurethral resection of the prostate performed by one surgeon: learning curve, surgical results and postoperative complications. Hinyokika Kiyo 52(8):609–614

    PubMed  Google Scholar 

  19. Kailavasan M, Berridge C, Athanasiadis G, Gentzkis A, Rai B, Jain S, Biyani CS, Nabi G (2020) Design, implementation, and evaluation of a novel curriculum to teach transurethral resection of the prostate (TURP): a 3-year experience of urology simulation bootcamp course. World J Urol. https://doi.org/10.1007/s00345-020-03104-3 (Online ahead of print)

    Article  PubMed  Google Scholar 

  20. Rasyid N, Putra HWK, Birowo P, Wahyudi I, Mochtar CA, Hamid ARAH (2020) TUR-P phantom for resident surgical training: food-based design as a human mimicking model of the prostate. World J Urol. https://doi.org/10.1007/s00345-020-03085-3 (Online ahead of print)

    Article  PubMed  Google Scholar 

  21. Cornu JN, Ahyai S, Bachmann A, de la Rosette J, Gilling P, Gratzke C, McVary K, Novara G, Woo H, Madersbacher S (2015) A systematic review and meta-analysis of functional outcomes and complications following transurethral procedures for lower urinary tract symptoms resulting from benign prostatic obstruction: an update. Eur Urol 67(6):1066–1096

    Article  Google Scholar 

  22. Muntener M, Aellig S, Kuttel R, Gehrlach C, Hauri D, Strebel RT (2006) Peri-operative morbidity and changes in symptome scores after transurethral prostatectomy in Switzerland: results of an independent assessment of outcome. BJU Int 98(2):381–383

    Article  Google Scholar 

  23. Mayer EK, Kroeze SG, Chopra S, Bottle A, Patel A (2012) Examining the ‘gold standard’: a comparative critical analysis of three consecutive decades of monopolar transurethral resection of the prostate (TURP) outcomes. BJU Int 110(11):1595–1601

    Article  Google Scholar 

  24. Millin T (1932) A short note on endoscopic resection of the prostate. Postgrad Med J 8(83):354–355

    Article  CAS  Google Scholar 

  25. Muntener M, Aellig S, Kuettel R, Gehrlach C, Sulser T, Strebel RT (2007) Sexual function after transurethral resection of the prostate (TURP): results of an independent prospective multicentre assessment of outcome. Eur Urol 52(2):510–515

    Article  Google Scholar 

  26. Alloussi SH, Lang C, Eichel R, Alloussi S (2014) Ejaculation-preserving transurethral resection of prostate and bladder neck: short- and long-term results of a new innovative resection technique. J Endourol 28(1):84–89

    Article  Google Scholar 

  27. Gul Z, Chughtai B, Te AE, Thomas D, Kaplan SA (2019) Ejaculatory preserving middle lobe onl-transurethral resection and vaporization of the prostate: 12-year experience. Urology 134:199–202

    Article  Google Scholar 

  28. Eskenazi B, Wyrobek AJ, Sloter E, Kidd SA, Moore L, Young S, Moore D (2003) The association of age and semen quality in healthy men. Hum Reprod 18(2):447–454

    Article  CAS  Google Scholar 

  29. Lebdai S, Chevrot A, Doizi S, Pradere B, Delongschamps NB, Benchikh A, Cornu JN, Della Negra E, Fourmarier M, Misraï V, Theveniaud PE, Descazeaud A, Robert G, CTMH-AFU Group (2019) Do patients have to choose between ejaculation and miction? A systematic review about ejaculation preservation technics for benign prostatic obstruction surgical treatment. World J Urol 37(2):299–308

    Article  Google Scholar 

  30. Becher EF, McVary KT (2014) Surgical procedures for BPH/LUTS: Impact on male sexual health. Sex Med Rev 2(1):47–55

    Article  Google Scholar 

  31. Mishriki SF, Grimsley SJ, Lam T, Nabi G, Cohen NP (2012) TURP and sex: patient and partner prospective 12 years follow-up study. BJU Int 109(5):745–750

    Article  Google Scholar 

  32. Brookes ST, Donovan JL, Peters TJ, Abrams P, Neal DE (2002) Sexual dysfunction in men after treatment for lower urinary tract symptoms: evidence from randomised controlled trial. BMJ 324(7345):1059–1061

    Article  Google Scholar 

  33. Koshiba K, Egawa S, Ohori M, Uchida T, Yokoyma E, Shoji K (1995) Does transurethral resection of the prostate pose a risk to life? 22-year outcome. J Urol 153(5):1506–1509

    Article  CAS  Google Scholar 

  34. Reich O, Gratzke C, Stief CG (2006) Techniques and long-term results of surgical procedures for BPH. Eur Urol 49(6):970–978

    Article  Google Scholar 

  35. Masumori N, Furuya R, Tanaka Y, Furuya S, Ogura H, Tsukamoto T (2010) The 12-year symptomatic outcome of transurethral resection of the prostate for patients with lower urinary tract symptoms suggestive of benign prostatic obstruction compared to urodynamic findings before surgery. BJU Int 105(10):1429–1433

    Article  Google Scholar 

  36. Zwergel U, Wullich B, Lindenmeir U, Rohde V, Zwergel T (1998) Long-term results following transurethral resection of the prostate. Eur Urol 33(5):476–480

    Article  CAS  Google Scholar 

  37. Eredics K, Wachabauer D, Röthlin F, Madersbacher S, Schauer I (2018) Reoperation rates and mortality after transurethral and open prostatectomy in a long-term nationwide analysis: have we improved over a decade? Urology 118:152–157

    Article  Google Scholar 

  38. Reich O, Gratzke C, Bachmann A, Seitz M, Schlenker B, Hermanek P, Lack N, Stief CG, Urology Section of the Bavarian Working Group for Quality Assurance (2008) Morbidity, mortality and early outcome of transurethral resection of the prostate: a prospective multicenter evaluation of 10,654 patients. J Urol 180(1):246–249

    Article  Google Scholar 

  39. Garske GL, Phares OC, Sweetser TH (1949) The status of irrigating fluids for transurethral resection: our experience and a survey of the use of various solutions by others. J Urol 62(3):322–327

    Article  CAS  Google Scholar 

  40. De Witt-Foy ME, Gill BC, Ulchaker JC (2019) Cost comparison of benign prostatic hyperplasia treatment options. Curr Urol Rep 20(8):45. https://doi.org/10.1007/s11934-019-0907-3

    Article  Google Scholar 

  41. Pham R, Parke J, Kernen KM (2016) How I do it: same day discharge for transurethral resection of the prostate using Olympus PlasmaButton and PlasmaLoop. Can J Urol 23(5):8491–8494

    PubMed  Google Scholar 

  42. Salciccia S, Del Giudice D, Maggi M, Eisenberg M, Chung BI, Conti SL et al (2020) Safety and feasibility of outpatient surgery in benign prostatic hyperplasia: a systematic review and meta-analysis. J Endourol. https://doi.org/10.1089/end.2020.0538

    Article  Google Scholar 

  43. Ong WL, Koh TL, Fletcher J, Gruen R, Royce P (2015) Perioperative management of antiplatelets and anticoagulants among patients undergoing elective transurethral resection of the prostate—a single institution experience. J Endourol 29(11):1321–1327

    Article  Google Scholar 

  44. He Q, Yu Y, Gao F (2020) Meta-analysis of the effect of the antithrombotic drugs on perioperative bleeding in BPH surgery. Exp Ther Med 20(4):3807–3815

    PubMed  PubMed Central  Google Scholar 

  45. Fa LX, Zhou WW, Peng HY, Ke ZS, Jian H, Tao Z, Ling ZF, Chang LY, Lu DX, Chao C, Gurioli A, Tuo D, Qi WW (2020) Safety of surgery in benign prostatic hyperplasia patients on antiplatelet or anticoagulant therapy: a systematic review and meta-analysis. Urol J. https://doi.org/10.22037/uj.v16i7.5974

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Urology, Kantonsspital Graubünden, Loësstr. 170, 7000, Chur, Switzerland

    Räto T. Strebel

  2. Icahn School of Medicine at Mount Sinai, 625 Madison Avenue, New York, USA

    Steven A. Kaplan

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RTS, SAK: manuscript writing.

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Correspondence to Räto T. Strebel.

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Strebel, R.T., Kaplan, S.A. The state of TURP through a historical lens. World J Urol 39, 2255–2262 (2021). https://doi.org/10.1007/s00345-021-03607-7

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