[Postoperative urological complications of transurethral electrosurgical interventions on the prostate for adenoma].
The aim of the study was comparison of urological complications after transurethral resection and its low-invasive alternatives: vaporization, rotoresection, vaporization resection, prostatic incision. Case histories were studied of 5401 patients operated endoscopically for prostatic adenoma in 1991-2003. Standard TUR was made in 5003 patients, incision--in 112, vaporization--in 119, vaporizing resection--in 107, rotoresection--in 60 patients. Of early complications after TUR hemorrhage was the most dangerous, hemotransfusion was made in 3.9% cases. No hemorrhagic complications occurred in rotoresection, no hemotransfusions were made in vaporization and vaporizing resection, prostatic incision was complicated by hemorrhage only in 0.9% cases. By infection complications rate (0.9-7.5%), the differences were not significant. Of late complications, sclerosis of the urinary bladder cervis was most frequent (10.7-11.2%) after rotoresection and vaporizing resection, urethral stricture--after TUR (6.9%). By number of complications, incision was least invasive. Thus, basic problem after TUR is hemorrhage. Low-invasive alternative methods resolve this problem. But they have limitations. The best way out is improvement of intraoperative hemostasis during TUR.
Martov
A G
AG
Merinov
D S
DS
Kornienko
S I
SI
Gushchin
B L
BL
Ergakov
D V
DV
Mustafaev
E M
EM
Borisenko
E A
EA
D004598:Electrosurgery; D006801:Humans; D007239:Infections / Q000175:diagnosis / Q000628:therapy; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis* / Q000628:therapy; D019106:Postoperative Hemorrhage / Q000175:diagnosis* / Q000628:therapy; D011468:Prostatectomy / Q000379:methods; D011470:Prostatic Hyperplasia / Q000601:surgery*; D020728:Transurethral Resection of Prostate; D016896:Treatment Outcome; D001745:Urinary Bladder Diseases / Q000175:diagnosis / Q000628:therapy