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Palliative transurethral resection of the prostate: functional outcome and impact on survival

Palliative transurethral resection of the prostate: functional outcome and impact on survival 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. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png BJU International Wiley

Palliative transurethral resection of the prostate: functional outcome and impact on survival

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References (20)

Publisher
Wiley
Copyright
Copyright © 2007 Wiley Subscription Services, Inc., A Wiley Company
ISSN
1464-4096
eISSN
1464-410X
DOI
10.1111/j.1464-410X.2006.06529.x
pmid
17034496
Publisher site
See Article on Publisher Site

Abstract

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.

Journal

BJU InternationalWiley

Published: Jan 1, 2007

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