Postoperative urological complications of transurethral electrosurgical interventions on the prostate for adenoma
Martov, A.G.; Merinov, D.S.; Kornienko, S.I.; Gushchin, B.L.; Ergakov, D.V.; Mustafaev, E.M.; Borisenko, E.A.
Urologiia 2006(2): 25-32
2006
ISSN/ISBN: 1728-2985 PMID: 16708585 Document Number: 603698
The aim of the study was comparison of urological complications after transurethral resection and its low-invasive alternatives: vaporization, rotoresection, vaporization resection, prostatic incision. Case histories were studied of 5401 patients operated endoscopically for prostatic adenoma in 1991-2003. Standard TUR was made in 5003 patients, incision - in 112, vaporization - in 119, vaporizing resection - in 107, rotoresection - in 60 patients. Of early complications after TUR hemorrhage was the most dangerous, hemotransfusion was made in 3.9% cases. No hemorrhagic complications occurred in rotoresection, no hemotransfusions were made in vaporization and vaporizing resection, prostatic incision was complicated by hemorrhage only in 0.9% cases. By infection complications rate (0.9-7.5%), the differences were not significant. Of late complications, sclerosis of the urinary bladder cervis was most frequent (10.7-11.2%) after rotoresection and vaporizing resection, urethral stricture - after TU R (6.9%). By number of complications, incision was least invasive. Thus, basic problem after TUR is hemorrhage. Low-invasive alternative methods resolve this problem. But they have limitations. The best way out is improvement of intraoperative hemostasis during TUR.