The Effect of a Transition Zone Resection Rate of the Transurethral Resection of Prostate (TURP) according to the Prostate Volume / 대한비뇨기과학회지

ABSTRACT

PURPOSE: Transurethral resection of prostate (TURP) was the gold standard for the treatment of benign prostatic hyperplasia (BPH). BPH is the enlargement of the transition zone; so a TURP was the resection of the enlarged transition zone. The transition zone resection rate is important if a good result is expected. The effect of the transition zone resection rate of TURP was evaluated according to the prostate volume. MATERIALS AND METHODS: Between January 2000 and December 2003, 61 patients with symptomatic BPH, who had undergone TURP by one surgeon, were enrolled in this retrospective study. 25 patients with a BPH less than 60cc (Group I), and 36 equal or greater than 60cc (Group II) were evaluated using the International Prostate Symptom Score (IPSS), uroflowmetry and post voiding residual urine volume (PRV) both before and after the TURP. The total prostate volume, transition zone volume (TZV), transition zone resection ratio (TZRR), total volume of resected prostate, operating time, period of hospital stay and complications were assessed. RESULTS: In groups I and II, the TZV was 21.3 6.9cc and 38 19.5cc (p=0.43), respectively. The resected prostate volumes were 16.5 7.1gm and 26.6 10.34gm in groups I and II (p=0.050), respectively. The TZRR were equal, at 0.8 0.4, in both groups. The postoperative IPSS, voiding volume, PRV and maximal flow rate (Qmax) were significantly improved in both groups. Overall, the IPSS, VV and PRV were significantly improved after the TURP when the TZRR was greater than 0.5. However, the Qmax was significantly improved when the TZRR was greater than 0.7. There were no significant differences in the periods of hospital stay or complications between the two groups. CONCLUSIONS: With TURP, the transition zone resection ratio was important, without concern of the prostate size. Also, to obtain good results, more than 70% of the enlarged transition zone has to be resected.