Monopolar Transurethral Resection of the Prostate: Evaluation of the Results in the Urology Department of the Sino-Guinean Friendship Hospital in Conakry (Guinea)
Introduction: The therapeutic approach to benign prostatic hyperplasia (BPH) has evolved profoundly. Surgical treatment is reserved for complicated cases and the reference surgical technique is transurethral resection of the prostate (TURP). This work aims to study the epidemiological, clinical and therapeutic aspects of monopolar transurethral resection of the prostate in our department. Materials and Methods: We conducted a descriptive study with retrospective data collection over a 12-month period from November 1, 2023 to December 31, 2024. The urology unit, an integral part of the surgery department, of the Sino-Guinean Friendship Hospital in Conakry served as the setting for this study. It included 27 patients with benign prostatic hypertrophy treated surgically by monopolar transurethral resection and having a usable medical record. The parameters studied were epidemiological, clinics and therapeutic. Results: The mean age of the patients was 68.57 ± 5.7 years with extremes from 50 to 79 years. The peak frequency was observed between 70 and 79 years (48.15%). All our patients had lower urinary tract disorders, i.e. 100% of cases. On digital rectal examination, an increase in the volume of the prostate of benign appearance was observed in all cases. The mean prostate volume was 43.7 cc on ultrasound with extremes from 34 cc to 58 cc. The total PSA level was less than 4 ng/ml in the majority of cases. The postoperative course was generally uncomplicated (n = 26) with removal of the urinary catheter on the second postoperative day (D2). However, one peroperative complication was observed in one patient; it was a bladder breach, leading to the passage of glycine into the peritoneum. Conclusion: Transurethral resection of the prostate has reduced the length of hospital stay of our patients, as well as the comorbidities associated with the treatment. The complications associated with it are rare but potentially serious. Its performance requires in-depth mastery of the endoscopic anatomy of the lower urinary tract as well as technical operative expertise.
References
[1]
Lahlaidi, K., etal. (2014) Updates on the Management of Benign Prostatic Hyperplasia. Which Adenoma to Treat and How? TheJournalofInternalMedicine, 35, 189-195.
[2]
Platz, E.A., Smit, E., Curhan, G.C., Nyberg, L.M. and Giovannucci, E. (2002) Prevalence of and Racial/Ethnic Variation in Lower Urinary Tract Symptoms and Noncancer Prostate Surgery in U.S. Men. Urology, 59, 877-883. https://doi.org/10.1016/s0090-4295(01)01673-9
[3]
Benign Prostatic Hyperplasia Collaborators (GBD) (2022) The Global, Regional, and National Burden of Benign Prostatic Hyperplasia in 204 Countries and Territories from 2000 to 2019: A Systematic Analysis for the Global Burden of Disease Study 2019. The Lancet Healthy Longevity, 30, 754-776. https://doi.org/10.1016/S2666-7568(22)00213-6
[4]
Lin, Y., Hou, C., Chen, T., Juang, H., Chang, P., Yang, P., etal. (2018) Transurethral Resection of the Prostate Provides More Favorable Clinical Outcomes Compared with Conservative Medical Treatment in Patients with Urinary Retention Caused by Benign Prostatic Obstruction. BMCGeriatrics, 18, Article No. 15. https://doi.org/10.1186/s12877-018-0709-3
[5]
Seisen, T. and Xylinas, E. (2015) Benign Prostatic Hypertrophy AFU Chapter 10 Item 123-UE5. AFU/EAU 2012/2015.
[6]
Lebdai, S., Robert, G., Devonnec, M., Fourmarier, M., Haillot, O., Saussine, C., etal. (2009) Prise en charge des patients sous traitement antithrombotique dans la résection transurétrale de prostate: Étude multicentrique du CTMH de l’Afu. ProgrèsenUrologie, 19, 553-557. https://doi.org/10.1016/j.purol.2009.04.009
[7]
Horninger, W., Unterlechner, H., Strasser, H. and Bartsch, G. (1996) Transurethral Prostatectomy: Mortality and Morbidity. TheProstate, 28, 195-200. https://doi.org/10.1002/(sici)1097-0045(199603)28:3<195::aid-pros6>3.0.co;2-e
[8]
Kambou, T., Zango, B., Ekoué, F., Traoré, A.C., Bonkoungou, B., Ouattara, T., et al. (2006) Surgical Treatment of Benign Prostatic Hypertrophy at the Sanou Souro University Hospital in Bobo-Dioulasso (Burkina Faso)—Short and Medium Term Results—About 190 Cases. Médecined’AfriqueNoire, 53, 605-612.
[9]
Borboroglu, P.G., Kane, C.J., Ward, J.F., Roberts, J.L. and Sands, J.P. (1999) Immediate and Postoperative Complications of Transurethral Prostatectomy in the 1990s. JournalofUrology, 162, 1307-1310. https://doi.org/10.1016/s0022-5347(05)68272-9
[10]
Wasson, J.H., Reda, D.J., Bruskewitz, R.C., Elinson, J., Keller, A.M. and Henderson, W.G. (1995) A Comparison of Transurethral Surgery with Watchful Waiting for Moderate Symptoms of Benign Prostatic Hyperplasia. NewEnglandJournalofMedicine, 332, 75-79. https://doi.org/10.1056/nejm199501123320202
[11]
Lepage, J.Y., Rivault, O., Karam, G., Malinovsky, J.M., Le Gouedec, G., Cozian, A., etal. (2005) Anesthésie et chirurgie de la prostate. AnnalesFrançaisesd’AnesthésieetdeRéanimation, 24, 397-411. https://doi.org/10.1016/j.annfar.2005.01.019
[12]
Issa, M.M. (2008) Technological Advances in Transurethral Resection of the Prostate: Bipolar versus Monopolar TURP. JournalofEndourology, 22, 1587-1596. https://doi.org/10.1089/end.2008.0192
[13]
Sissoko, F., Dembélé, O., Dembélé, A., Badiaga, C., Koné, S., Touré, S., etal. (2023) Transurethral Resection of the Prostate: Assessment of the First Year of Practice at the Urology Department of Sikasso Hospital. Health Sciences and Disease, 24, 135-137.
[14]
Ndiath, A., Sarr, A., Malick Diaw, E.H., Sow, O., Ndiaye, M., Sine, B., etal. (2021) Morbi-mortalité de la résection trans-urétrale bipolaire de la prostate au Service d’Urologie-Andrologie de l’Hôpital Aristide Le Dantec de Dakar. PAMJClinicalMedicine, 5, Article 75. https://doi.org/10.11604/pamj-cm.2021.5.75.27226
[15]
Rassweiler, J., Teber, D., Kuntz, R. and Hofmann, R. (2006) Complications of Transurethral Resection of the Prostate (TURP)—Incidence, Management, and Prevention. EuropeanUrology, 50, 969-980. https://doi.org/10.1016/j.eururo.2005.12.042