Safety and efficacy of transurethral resection of prostate gland up to 150 mls: a prospective comparative study with 1 year follow-up

Purpose: We investigated the safety and efficacy of transurethral resection of the prostate (TURP) for prostate glands between 70 and 150 ml. Materials and Methods: We prospectively evaluated 113 patients treated with TURP for benign prostatic hyperplasia. A total of 57 patients with a prostate volume of less than 70 ml were assigned to group 1, while 56 with a prostate volume of between 70 and 150 ml were assigned to group 2. Preoperative parameters considered in each patient were prostate volume, International Prostate Symptom Score (I-PSS), urinary flow rate measurement (Qmax) and post-void residual urine volume (PVR). Operative time, resected tissue weight and all complications were recorded. All patients were evaluated 3 months and 1 year postoperatively. Preoperative, perioperative and postoperative data on the 2 groups were compared. Results: Each group achieved significant improvement in I-PSS, Qmax and PVR. Operative time was significantly longer in group 2 but the complication rate was similar in the 2 groups. Group 2 resulted in better improvements in Qmax and I-PSS. At 1 year of followup PVR was significantly lower in group 1 than in group 2. Multivariate analysis revealed that only age was a significant independent predictor of complications, and only age and initial Qmax were independent predictive variables of outcome. Conclusions: TURP for large prostate glands is a safe procedure without showing a different complication rate compared with TURP for recommended volumes. Patients with a baseline prostate volume of greater than 70 ml seem to achieve better improvement in obstruction and symptoms.