Hemiresection of the prostate: short-term randomized comparison with standard transurethral resection

Area of Science:

• Urology
• Surgical Oncology

Background:

• Transurethral resection of the prostate (TURP) can be prolonged in patients with large, vascular glands, posing risks for medically compromised individuals.
• Fluid absorption and bleeding complications may necessitate early termination of standard TURP.
• Prostatic hemiresection, involving resection of one lateral lobe and the median lobe, is proposed as an alternative.

Purpose of the Study:

• To compare the efficacy and safety of prostatic hemiresection versus standard TURP.
• To evaluate hemiresection as a viable option for medically compromised patients with large prostates.

Main Methods:

• A randomized trial involving 161 men with prostates >50 cc.
• Group 1 (80 patients) underwent standard TURP.
• Group 2 (81 patients) underwent prostatic hemiresection.
• Preoperative and postoperative parameters were compared using Student's t-test.

Main Results:

• Hemiresection (Group 2) demonstrated significantly shorter resection times and lower operative blood loss compared to standard TURP (Group 1).
• Resected tissue weight was greater in the standard TURP group.
• Both groups showed comparable improvements in symptom scores and urinary flow rates.

Conclusions:

• Prostatic hemiresection provides short-term functional outcomes similar to standard TURP for large prostates (>50 cc).
• The procedure offers reduced operative duration and blood loss.
• Hemiresection is a safe and acceptable surgical alternative for medically compromised patients with significant comorbidities.