title: [The low hydraulic pressure transurethral resection of the prostate results in 340 patients with great adenomas].
abstract: BACKGROUND
  the transurethral resection of prostate TURP is the elective treatment for the small and medium adenomas. In this study they analyse the effectiveness, the results and the postoperative morbidity in the resection of the great adenomas.
  
  
  METHODS
  We study 340 patients with great adenomas and symptomatic infravesical obstruction that were operated with the low hydraulic pressure RTUP between August of 1999 and June of 2006.
  
  
  RESULTS
  Average Age of the patients 69 years (range 51-89). Prostate volume by TRUS, 107 ml (70-204). PSA 7,94 ng/ml (0,71-26,4). Weight of the resected fragments: 74,5gr. (50-160), time of the intervention 65 min. (35-155), postoperative urethral catheterisation 1.7 days (1-8), suprapubic derivation 6.5 days (5-15), the duration of hospital stay after surgery were 8 days (7-16), peak flow pre-op. 11.2 ml/sec. (5-15,7), post-operative 19.7 ml/sec. (7-41,3). There were no cases of TURP syndrome in this group. Operative complications: Urinary infection without fever (bacteria >100.000) 95 patients (27.9%), bladder derivation by preoperative urinary retention 53 patients (15,6%). 18 patients (5,3%) with postoperative urinary retention. 11 patients (3,2%), with infection and fever >38 degrees C. 7 patients (2%) with postoperative bladder bleeding, 2 patients (0,6%) with urethral lesion. 1 patient (0.3%), with massive scrotal hematoma (after vasectomy). Control of the pre and post operative hemoglobin: Hemoglobin pre-op 15 g/dl (12-19,3), hemoglobin post-op 11,5 g/dl (7,6-16,4), difference of (- 3,5g/dl) 23,3%. In only 29 patients (8.5%) it was necessary to carry out a sanguineous transfusions (heterolog) of 2 to 4 EC (500 ml), the TRUS was 125 ml, weight of the fragments 90 gr. (52-140), the hemoglobin pre-op was 14,72g/dl and post-op of 8,8g/dl with a difference of (- 5,92g/dl) 40.2%.
  
  
  CONCLUSIONS
  The video assisted low hydraulic pressure TURP, is an effective method in the surgical treatment of great prostate adenomas. The severe postoperative complications are little, and in 311 patients (91.5%) it was not necessary sanguineous transfusion. The stationary treatment and the urethral catheterisation is smaller in comparison with the open adenomectomy.
authors.affiliation: Reuter Klink, Servicio de Urología, Hospital Karl-Olga, Hospital Escuela Dependiente de la Universidad de Ulm, Stuttgart Alemania. andresbverger@aol.com
authors.forename: A B
authors.initials: AB
authors.lastname: Verger-Kuhnke
authors.forename: M A
authors.initials: MA
authors.lastname: Reuter
authors.forename: W
authors.initials: W
authors.lastname: Epple
authors.forename: G
authors.initials: G
authors.lastname: Ungemach
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D008875:Middle Aged; D011312:Pressure; D011470:Prostatic Hyperplasia / Q000097:blood / Q000601:surgery*; D012189:Retrospective Studies; D007507:Therapeutic Irrigation / Q000379:methods; D020728:Transurethral Resection of Prostate / Q000379:methods*