Transurethral resection versus incision of the prostate: a randomized, prospective study

Area of Science:

• Urology
• Surgical Innovation
• Men's Health

Background:

• Benign prostatic hyperplasia (BPH) is a common condition causing bladder outlet obstruction.
• Transurethral resection (TURP) and transurethral incision (TUIP) are surgical options for BPH.
• Longer-term comparative data for TURP and TUIP in smaller prostates are limited.

Purpose of the Study:

• To compare the long-term efficacy of TURP and TUIP in patients with smaller prostates.
• To evaluate urinary symptoms, sexual function, and uroflowmetry outcomes post-surgery.

Main Methods:

• A randomized prospective study involving 120 patients with smaller benign prostates (<20g).
• Patients were assigned to either TURP or TUIP.
• Evaluations included urinary symptoms (Madsen's questionnaire), sexual function, and uroflowmetry at regular intervals, with a mean follow-up of 34 months.

Main Results:

• Both TURP and TUIP significantly improved urinary symptoms and peak flow rates.
• No statistically significant differences were observed in symptom scores or peak flow rates between the groups.
• Retrograde ejaculation was significantly more common after TURP (68%) compared to TUIP (35%).

Conclusions:

• TURP and TUIP demonstrate comparable long-term effectiveness in relieving BPH-related bladder outlet obstruction for small prostates.
• Transurethral incision (TUIP) is an effective and potentially underutilized surgical option for BPH management.
• The choice between TURP and TUIP may consider the higher risk of retrograde ejaculation with TURP.