Abstract
Transurethral resection of the prostate (TURP) continues to be the most common treatment in the operative management of benign prostatic hypertrophy (BPH). Several other modalities have shown equivalence to TURP. However, even after surgical treatment, up to one third of patients have bothersome lower urinary tract symptoms (LUTS). This review discusses the pathophysiology, evaluation, and management options for patients with LUTS after TURP.
Similar content being viewed by others
References
Papers of particular interest, published recently, have been highlighted as: • Of importance
Abrams PH, Farrar DJ, Turner-Warwick RT, et al. The results of Smith RD and Patel A. Transurethral resection of the prostate revisited and updated. Curr Opin Urol. 2011;21:36–41.
Nitti VW, Kim Y, Combs AJ. Voiding dysfunction following transurethral resection of the prostate: symptoms and urodynamic findings. J Urol. 1997;157(2):600–3.
Rigatti L, Naspro R, Salonia A, et al. Urodynamics after TURP and HoLEP in urodynamically obstructed patients: are there any differences at 1 year of follow-up? Urology. 2006;67(6):1193–8.
Donovan JL, Peters TJ, Neal DE, et al. A randomized trial comparing transurethral resection of the prostate, laser therapy and conservative treatment of men with symptoms associated with benign prostatic enlargement: the CLasP study. J Urol. 2000;164(1):65–70.
Strope SA, Yang L, Nepple KG, et al. Population based comparative effectiveness of transurethral resection of the prostate and laser therapy for benign prostatic hyperplasia. J Urol. 2012;187(4):1341–5. This population based study utilizing data from the Agency for Healthcare Research and Quality is one of the few comparing the long- term efficacy of TURP and laser procedures for BPH.
Hoekstra RJ, Van Melick HH, Kok ET, Ruud Bosch JL. A 10-year follow-up after transurethral resection of the prostate, contact laser prostatectomy and electrovaporization in men with benign prostatic hyperplasia; long-term results of a randomized controlled trial. BJU. 2010;106(6):822–6. This is an important paper comparing the long-term results of TURP, contact laser prostatectomy, and electrovaporization.
Mirone VC, Imbimbo C, Longo N, et al. The detrusor muscle: an innocent victim of bladder outlet obstruction. Eur Urol. 2007;51(1):57–66.
Steers WD. Pathophysiology of overactive bladder and urge urinary incontinence. Rev Urol. 2002;4 Suppl 4:S7–S18.
Housami F, Abrams P. Persistent detrusor overactivity after transurethral resection of the prostate. Curr Urol Rep. 2008;9(4):284–90.
de Nunzio C, Franco G, Rocchegiani A, et al. The evolution of detrusor overactivity after watchful waiting, medical therapy and surgery in patients with bladder outlet obstruction. J Urol. 2003;169(2):535–9.
Abrams PH, Farrar DJ, Turner-Warwick RT, et al. The results of prostatectomy: a symptomatic and urodynamic analysis of 152 patients. J Urol. 1979;121:160.
Speakman MJ, Brading AF, Gilpin CJ, et al. Bladder outflow obstruction–a cause of denervation supersensitivity. J Urol. 1987;138(6):1461–6.
Mayer EK, Kroeze SG, Chopra S, et al. Examining the ‘gold standard’: a comparative critical analysis of three consecutive decades of monopolar transurethral resection of the prostate (TURP) outcomes. BJU Int. 2012;110(11):1595–601.
Anutrakulchai S. Residual lower urinary tract symptoms (LUTS) after transurethral resection of prostate (TURP): the urodynamic studies in Chiang Mai University Hospital. Thai J Surg. 2005;26:82–7.
Djavan B, Madersbacher S, et al. Urodynamic assessment of patients with acute urinary retention: is treatment failure after prostatectomy predictable? J Urol. 1997;158(5):1829–33.
Fujita K, Kimura T, Saito K, et al. Epididymitis after transurethral prostatectomy. Clin Ther. 1988;10:56–9.
Krambeck AE, Handa SE, Lingeman JE. Experience with more than 1,000 holmium laser prostate enucleations for benign prostatic hyperplasia. J Urol. 2010;183(3):1105–9.
Kabalin JN. Laser prostatectomy performed with a right angle firing neodymium: YAG laser fiber at 40 watts power setting. J Urol. 1993;150:95–9.
Kabalin JN, Gill HS, Bite G. Laser prostatectomy performed with a right angle firing neodymium: YAG laser fiber at 60 watts power setting. J Urol. 1995;153:1502–5.
Cowles RS, Kabalin JN, Childs S, et al. A prospective randomized study comparison of transurethral resection to visual laser ablation of the prostate for the treatment of benign prostatic hyperplasia. Urology. 1995;46:155–60.
Kabalin JN, Bite G. Three-year experience with Nd: YAG laser coagulation prostatectomy in 225 patients. J Urol. 1995;153:229A.
Monoski MA, Gonzalez RR, Sandhu JS, et al. Urodynamic predictors of outcomes with photoselective laser vaporization prostatectomy in patients with benign prostatic hyperplasia and preoperative retention. Urology. 2006;68(2):312–7.
Kuo HC. Analysis of the pathophysiology of lower urinary tract symptoms in patients after prostatectomy. Urol Int. 2002;68(2):99–104.
Roth B, Studer UE, Fowler CJ, et al. Benign prostatic obstruction and Parkinson’s disease—should transurethral resection of the prostate be avoided? J Urol. 2009;181:2209–13.
Tasci A, Ilbey YO, Tugcu V, et al. Transurethral resection of the prostate with monopolar resectoscope: single-surgeon experience and long-term results of after 3589 procedures. Urology. 2011;78(5):1151–5.
Van Melick HH, Van Venrooij G, Eckhardt MD, et al. A randomized controlled trial comparing transurethral resection of the prostate, contact laser prostatectomy and electrovaporization in men with benign prostatic hyperplasia: urodynamic effects. J Urol. 2002;168:1058–62.
Rassweiler J, Teber D, Kuntz R, et al. Complications of transurethral resection of the prostate (TURP)–incidence, management, and prevention. Eur Urol. 2006;50(5):969–79. discussion 980.
Roehrborn CG. BPH progression: concept and key learning from MTOPS, ALTESS, COMBAT, and ALF-ONE. BJU Int. 2008;101 Suppl 3:17–21.
Machino R, Kakizaki H, Ameda K, et al. Detrusor instability with equivocal obstruction: a predictor of unfavorable symptomatic outcomes after transurethral prostatectomy. Neurourol Urodyn. 2002;21(5):444–9.
Reynard JM, Shearer RJ. Failure to void after transurethral resection of the prostate and mode of presentation. Urology. 1999;53(2):336–9.
Weissbart SJ, Chughtai B, Elterman D, et al. Acetylcholine for male LUTS. Curr Urol Rep. 2012;13(6):413–9.
Roehrborn CG. Current medical therapies for men with lower urinary tract symptoms and benign prostatic hyperplasia: achievements and limitations. Rev Urol. 2008;10(1):14–25.
Staskin DS, Vardi Y, Siroky MB. Post-prostatectomy continence in the parkinsonian patient: the significance of poor voluntary sphincter control. J Urol. 1988;140:117.
Hou CP, Chen TY, et al. Use of the SF-36 quality of life scale to assess the effect of pelvic floor muscle exercise on aging males who received transurethral prostate surgery. Clin Interv Aging. 2013;8:667–73. This paper discusses the role of pelvic floor physical therapy in patients after failure of TURP.
Compliance with Ethics Guidelines
Conflict of Interest
Dr. Bilal Chughtai, Dr. Vannita Simma-Chiang, and Dr. Steven Kaplan each declare no potential conflicts of interest relevant to this article.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Author information
Authors and Affiliations
Corresponding author
Additional information
Bilal Chughtai and Vannita Simma-Chiang are co-first authors.
This article is part of the Topical Collection on Lower Urinary Tract Symptoms & Voiding Dysfunction
Rights and permissions
About this article
Cite this article
Chughtai, B., Simma-Chiang, V. & Kaplan, S.A. Evaluation and Management of Post-Transurethral Resection of the Prostate Lower Urinary Tract Symptoms. Curr Urol Rep 15, 434 (2014). https://doi.org/10.1007/s11934-014-0434-1
Published:
DOI: https://doi.org/10.1007/s11934-014-0434-1