Is the ability to perform transurethral resection of the prostate influenced by the surgeon's previous experience?
OBJECTIVE
To evaluate the influence of the urologist's experience on the surgical results and complications of transurethral resection of the prostate (TURP).


METHODS
Sixty-seven patients undergoing transurethral resection of the prostate without the use of a video camera were randomly allocated into three groups according to the urologist's experience: a urologist having done 25 transurethral resections of the prostate (Group I - 24 patients); a urologist having done 50 transurethral resections of the prostate (Group II - 24 patients); a senior urologist with vast transurethral resection of the prostate experience (Group III - 19 patients). The following were recorded: the weight of resected tissue, the duration of the resection procedure, the volume of irrigation used, the amount of irrigation absorbed and the hemoglobin and sodium levels in the serum during the procedure.


RESULTS
There were no differences between the groups in the amount of irrigation fluid used per operation, the amount of irrigation fluid absorbed or hematocrit and hemoglobin variation during the procedure. The weight of resected tissue per minute was approximately four times higher in group III than in groups I and II. The mean absorbed irrigation fluid was similar between the groups, with no statistical difference between them (p=0.24). Four patients (6%) presented with TUR syndrome, without a significant difference between the groups.


CONCLUSIONS
The senior urologist was capable of resecting four times more tissue per time unit than the more inexperienced surgeons. Therefore, a surgeon's experience may be important to reduce the risk of secondary TURP due to recurring adenomas or adenomas that were incompletely resected. However, the incidence of complications was the same between the three groups.
Department of Urology, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
José
J
Cury
Rafael Ferreira
RF
Coelho
Homero
H
Bruschini
Miguel
M
Srougi
D000368:Aged; D000891:Anti-Infective Agents, Local; D002983:Clinical Competence; D000431:Ethanol; D006801:Humans; D007010:Hyponatremia / Q000209:etiology; D007202:Indicators and Reagents / Q000493:pharmacokinetics; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011446:Prospective Studies; D011467:Prostate / Q000473:pathology / Q000601:surgery; D011787:Quality of Health Care; D013012:Sorbitol / Q000493:pharmacokinetics; D018709:Statistics, Nonparametric; D013577:Syndrome; D013997:Time Factors; D020728:Transurethral Resection of Prostate / Q000009:adverse effects / Q000592:standards*; D014572:Urology / Q000592:standards*
D000891:Anti-Infective Agents, Local; D007202:Indicators and Reagents; D000431:Ethanol; D013012:Sorbitol