Comparison of Early Versus Late Urethral Catheter Removal After Transurethral Resection of the Prostate in Patients with Benign Prostate Hyperplasia
Öz
Objective: Transurethral resection of the prostate (TURP) is considered the standard in the surgical therapy of lower urinary tract symptoms related to benign prostate hyperplasia (BPH). However, there is no consensus on the timing of catheter removal. In this study, we aimed to compare the long-term effects of early and delayed removal of urethral catheters who underwent TURP.
Methods: We prospectively analyzed a total of 91 patients who underwent TURP. Patients were randomized into two groups; the early (postop 1st-2nd days) and delayed (7th day) removal of the urethral catheter. After the surgery in 1, 3, and 6th months, we evaluated all patients regarding treatment success. In addition, international prostate symptom score (IPSS), quality of life (QoL), maximum flow rate, postvoid residual urine volume, and morbidities (hematuria, infection, urethral stricture, irritative symptoms, need for re-operation) were assessed at all visits.
Results: After TURP, there was no statistical difference in urodynamic parameters, complications, IPSS, and QoL in both groups. Only in the 3rd-month, the maximum flow rate was higher in favor of the early group. Despite similar results in both groups, strictures occurred earlier in the early group than delayed group (respectively 1 and 3 months).
Conclusion: These results suggest that there are no differences in efficacy and complications in groups of early or delayed urethral catheter removal after TURP. The results of long-term studies with large series should be awaited to reach a more definite conclusion. We have tried to shed light on a topic without consensus on the time of urethral catheterization after TURP.
Anahtar Kelimeler
Transurethral resection of the prostate (TURP) urethral catheter benign prostatic hyperplasia.
Kaynakça
- 1. Verhamme KM, Dieleman JP, Bleumink GS, van der Lei J, Sturkenboom MC, Artibani W, et al. Triumph Pan European Expert Panel. Incidence and prevalence of lower urinary tract symptoms suggestive of benign prostatic hyperplasia in primary care--the Triumph project. Eur Urol. 2002;42(4):323-8.
- 2. Thomas AW, Cannon A, Bartlett E, Ellis-Jones J, Abrams P. The natural history of lower urinary tract dysfunction in men: minimum 10-year urodynamic follow-up of transurethral resection of the prostate for bladder outlet obstruction. J Urol. 2005;174(5):1887-91.
- 3 Skolarus TA, Dauw CA, Fowler KE, Mann JD, Bernstein SJ, Meddings J. Catheter management after benign transurethral prostate surgery: RAND/UCLA Appropriateness Criteria. Am J Manag Care. 2019 1;25(12):e366-e372.
- 4. Li SX, Liu CX. Early removal of the urethral catheter after transurethral plasma kinetic resection of the prostate in the treatment of BPH. Zhonghua Nan Ke Xue. 2014;20(3):249-52.
- 5. Mamo GJ, Cohen SP. Early catheter removal vs. conventional practice in patients undergoing transurethral resection of prostate. Urology 1991;37:519-22.
- 6. Bhatta PN, Raya A, Yadav UK, Kumar V, Shahi S, Singh A. Median Duration of Hospital Stay after Early Removal of Foley's Catheter among Patients Undergoing Transurethral Resection of Prostate: A Descriptive Cross-sectional Study. JNMA J Nepal Med Assoc. 2021 30;59(239):688-91.
- 7. Durrani SN, Khan S, Ur Rehman A. Transurethral resection of prostate: early versus delayed removal of catheter. J Ayub Med Coll Abbottabad. 2014;26(1):38-41.
- 8. Mueller EJ, Zeidman EJ, Desmond PM, Thompson IM, Optenberg SA, Wasson J. Reduction of length of stay and cost of transurethral resection of the prostate by early catheter removal. British journal of urology. 1996;78(6):893-6.
- 9. Hammarsten J, Lindqvist K, Sunzel H. Urethral strictures following transurethral resection of the prostate: the role of the catheter. BJU Int, 1989;63:397-400.
- 10. Lumen N, Oosterlinck W. Challenging nontraumatic posterior urethral strictures treated with urethroplasty: A preliminary report. Int Braz J Urol, 2009;35(4):442-9.
- 11. Nielsen KK, Nordling J. Urethral stricture following transurethral prostatectomy. Urology, 1990;34:18-24.
- 12. Pansadoro V, Emiliozzi P. Iatrogenic prostatic urethral strictures: classification and endoscopic treatment. Urology, 1999;53:784-9.
- 13. Chander J, Vanitha V, Lal P, Ramteke VK. Transurethral resection of the prostate as catheter-free day-care surgery. BJU international. 2003;92(4):422-5.
- 14. Şahin C, Kalkan M. The effect of catheter removal time following transurethral resection of prostate on post-operative urinary retention. European Journal of General Medicine 2011;8(4):280-283.
- 15. Kunin CM, McCormack RC. Prevention of catheter-induced urinary-tract infections by sterile closed drainage. The New England journal of medicine. 1966;274(21):1155-61.
Benign Prostat Hiperplazili Hastalarda Transüretral Prostat Rezeksiyonu Sonrası Erken Ve Geç Üretral Kateter Çekilmesinin Sonuçlarının Karşılaştırılması
Öz
Amaç: Prostatın transüretral rezeksiyonu (TURP), benign prostat hiperplazisine (BPH) bağlı alt üriner sistem semptomlarının cerrahi tedavisinde standart olarak kabul edilir. Ancak, üretral kateterin çıkarılma zamanlaması konusunda görüş birliği yoktur. Biz çalışmamızda TURP sonrası üretral kateterin erken veya geç çıkarılmasının uzun dönem etkilerini karşılaştırmayı amaçladık.
Metod: TURP uygulanan toplam 91 hasta prospektif olarak incelendi. Hastalar üretral kateterin erken (postop 1.-2. gün) ve geç (7. gün) çıkarıldığı iki gruba randomize edildi. Ameliyat sonrası 1, 3 ve 6. aylarda tüm hastalar tedavi başarısı açısından değerlendirildi. Ek olarak, uluslararası prostat semptom skoru (IPSS), yaşam kalitesi (QoL), maksimum akış hızı, işeme sonrası rezidüel idrar hacmi ve morbiditeler (hematüri, enfeksiyon, üretral darlık, tahriş edici semptomlar, yeniden ameliyat ihtiyacı) tüm ziyaretlerde sorgulandı.
Bulgular: Ameliyat sonrası dönemde her iki grupta ürodinamik çalışma, komplikasyonlar, IPSS ve QoL açısından istatistiksel fark saptanmadı. Sadece 3. ayda maksimum akım hızının erken grupta daha yüksek olduğu görüldü. Ancak her iki grupta da benzer sonuçlara rağmen, üretral darlıkların erken grupta gecikmiş gruba göre daha erken (sırasıyla 1 ve 3 ay) meydana geldiği görüldü.
Sonuç: TURP sonrası üretral kateterizasyon zamanı konusunda, görüş birliği olmayan bir konuyu aydınlatmaya çalıştık. TURP sonrası üretral kateterin erken veya geç çıkarıldığı gruplar arasında etkinlik ve komplikasyonlar açısından herhangi bir farkın ortaya çıkmadığı saptanmıştır. Ancak daha kesin bir sonuca varmak için uzun süreli ve geniş serili çalışmaların sonuçları beklenmelidir.
Anahtar Kelimeler
Transüretral prostat rezeksiyonu (TURP) üretral kateter Benign Prostat Hiperplazisi.
Kaynakça
- 1. Verhamme KM, Dieleman JP, Bleumink GS, van der Lei J, Sturkenboom MC, Artibani W, et al. Triumph Pan European Expert Panel. Incidence and prevalence of lower urinary tract symptoms suggestive of benign prostatic hyperplasia in primary care--the Triumph project. Eur Urol. 2002;42(4):323-8.
- 2. Thomas AW, Cannon A, Bartlett E, Ellis-Jones J, Abrams P. The natural history of lower urinary tract dysfunction in men: minimum 10-year urodynamic follow-up of transurethral resection of the prostate for bladder outlet obstruction. J Urol. 2005;174(5):1887-91.
- 3 Skolarus TA, Dauw CA, Fowler KE, Mann JD, Bernstein SJ, Meddings J. Catheter management after benign transurethral prostate surgery: RAND/UCLA Appropriateness Criteria. Am J Manag Care. 2019 1;25(12):e366-e372.
- 4. Li SX, Liu CX. Early removal of the urethral catheter after transurethral plasma kinetic resection of the prostate in the treatment of BPH. Zhonghua Nan Ke Xue. 2014;20(3):249-52.
- 5. Mamo GJ, Cohen SP. Early catheter removal vs. conventional practice in patients undergoing transurethral resection of prostate. Urology 1991;37:519-22.
- 6. Bhatta PN, Raya A, Yadav UK, Kumar V, Shahi S, Singh A. Median Duration of Hospital Stay after Early Removal of Foley's Catheter among Patients Undergoing Transurethral Resection of Prostate: A Descriptive Cross-sectional Study. JNMA J Nepal Med Assoc. 2021 30;59(239):688-91.
- 7. Durrani SN, Khan S, Ur Rehman A. Transurethral resection of prostate: early versus delayed removal of catheter. J Ayub Med Coll Abbottabad. 2014;26(1):38-41.
- 8. Mueller EJ, Zeidman EJ, Desmond PM, Thompson IM, Optenberg SA, Wasson J. Reduction of length of stay and cost of transurethral resection of the prostate by early catheter removal. British journal of urology. 1996;78(6):893-6.
- 9. Hammarsten J, Lindqvist K, Sunzel H. Urethral strictures following transurethral resection of the prostate: the role of the catheter. BJU Int, 1989;63:397-400.
- 10. Lumen N, Oosterlinck W. Challenging nontraumatic posterior urethral strictures treated with urethroplasty: A preliminary report. Int Braz J Urol, 2009;35(4):442-9.
- 11. Nielsen KK, Nordling J. Urethral stricture following transurethral prostatectomy. Urology, 1990;34:18-24.
- 12. Pansadoro V, Emiliozzi P. Iatrogenic prostatic urethral strictures: classification and endoscopic treatment. Urology, 1999;53:784-9.
- 13. Chander J, Vanitha V, Lal P, Ramteke VK. Transurethral resection of the prostate as catheter-free day-care surgery. BJU international. 2003;92(4):422-5.
- 14. Şahin C, Kalkan M. The effect of catheter removal time following transurethral resection of prostate on post-operative urinary retention. European Journal of General Medicine 2011;8(4):280-283.
- 15. Kunin CM, McCormack RC. Prevention of catheter-induced urinary-tract infections by sterile closed drainage. The New England journal of medicine. 1966;274(21):1155-61.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Hizmetleri ve Sistemleri (Diğer) |
| Bölüm | Makaleler |
| Yazarlar | |
| Yayımlanma Tarihi | 20 Ekim 2023 |
| Kabul Tarihi | 7 Eylül 2023 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 15 Sayı: 3 |
