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How complete is a transurethral resection of the prostate?
J S Green1, P Bose, D P Thomas
1Department of Urology and Radiology, Royal Gwent Hospital, Newport, UK.
British Journal of Urology
|March 1, 1996
Summary
Transurethral resection of the prostate (TURP) may not be complete, as studies show significant prostate tissue often remains. This impacts prostate cancer detection and staging after TURP.
Area of Science:
- Urology
- Surgical Oncology
Background:
- Transurethral resection of the prostate (TURP) is a common procedure for benign prostatic hyperplasia.
- The completeness of tissue removal during TURP is crucial for patient outcomes and disease management.
Purpose of the Study:
- To evaluate the completeness of prostate tissue resection during TURP.
- To assess the relationship between prostate size and the percentage of tissue removed.
Main Methods:
- Prostate volume was measured using transrectal ultrasonography (TRUS) in 432 patients before TURP.
- Resected prostate tissue weight was measured, adjusted for shrinkage, and expressed as a percentage of pre-operative volume (resection ratio).
- Patients were grouped by pre-operative prostate size.
Main Results:
- The mean weight of resected prostate tissue was 25.6 g.
- Resection ratios increased with prostate size, peaking in prostates measuring 71-110 g.
- No patient group had more than 50% of the prostate gland volume resected.
Conclusions:
- This study challenges the assumption of routine complete prostate resection during TURP.
- Endoscopic appearance may suggest adenoma removal, but substantial gland volume can remain.
- Incomplete resection has significant implications for prostate cancer detection and staging following TURP.