Premium
Palliative transurethral resection of the prostate: functional outcome and impact on survival
Author(s) -
Marszalek Martin,
Ponholzer Anton,
Rauchenwald Michael,
Madersbacher Stephan
Publication year - 2007
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2006.06529.x
Subject(s) - medicine , prostate , urology , prostate cancer , bladder outlet obstruction , urinary retention , genitourinary system , transurethral resection of the prostate , surgery , cancer
OBJECTIVE To assess the long‐term functional and oncological outcome in a consecutive series of patients undergoing palliative transurethral resection of the prostate (pTURP). PATIENTS AND METHODS We retrospectively assessed all patients who had a pTURP between 1992 and 2004 at our institution. Patients with incidental prostate cancer (pT1a/pT1b) were excluded. In all, 89 patients (mean age 75.9 years, sd 0.9, at diagnosis) entered the study. RESULTS The median (range) prostate‐specific antigen level at diagnosis was 25.7 (0.7–5000) ng/mL and the mean Gleason score was 7. The mean ( sd , range) interval between the diagnosis of prostate cancer and pTURP was 1.5 (0.3, 0.5–10.9) years. The indications for pTURP were refractory urinary retention in 30%, severe bladder outlet obstruction with a postvoid residual urine volume of > 100 mL in 43%, and bladder stones, haematuria and hydronephrosis in 9% each. The mean ( sd , range) follow‐up after pTURP was 2.6 (0.2, 0.1–7.3) years. The peri‐operative mortality (<30 days) was 2%, and 22 patients (25%) died during the follow‐up. As estimated by Kaplan–Meier analysis, the 1‐, 2‐ and 5‐year survival rates were 83%, 70% and 61%, respectively. Patients with prostate cancer in the pTURP specimen had a shorter 3‐year survival (52%) than those with a negative histology (89%, P = 0.03). At the last follow‐up, 79% of men voided spontaneously and were continent. A repeat pTURP was necessary in 25% of patients, 11% required permanent catheterization and 10% were incontinent. CONCLUSION Despite greater peri‐operative mortality and morbidity than conventional TURP, pTURP is a fairly safe and effective procedure. Although a potential negative impact of pTURP on survival cannot be excluded, the estimated 5‐year survival of 61% in this series seems to justify this intervention.