Management of large prostatic adenoma: Lasers versus bipolar transurethral resection of prostate
Identifieur interne : 000204 ( Pmc/Curation ); précédent : 000203; suivant : 000205Management of large prostatic adenoma: Lasers versus bipolar transurethral resection of prostate
Auteurs : Narmada P. Gupta [Inde] ; Rishi Nayyar [Inde]Source :
- Indian Journal of Urology : IJU : Journal of the Urological Society of India [ 0970-1591 ] ; 2013.
Abstract
Transurethral resection of prostate (TURP) has long been the most commonly performed surgical procedure for the management of benign prostate enlargement (BPE), but has several associated limitations. Over the years, laser techniques have developed as major contenders as alternative therapies for BPE. However, simultaneously, TURP has also flourished and with relatively recent development of resection in saline (bipolar TURP), the tussle between laser techniques and TURP has further gained momentum. A systematic search was performed on Medline using the various Medical subject headings related to the surgical management of BPE including TURP, bipolar, lasers, holmium laser enucleation of prostate (HoLEP), photo-selective vaporization of prostate (PVP), etc., All articles types including meta-analysis randomized controlled trials, review articles, guidelines from various urological associations, single center studies from 2002 onward were considered for review. Bipolar TURP, HoLEP, and PVP provide equivalent outcomes for large prostate adenoma (<60 g). For extremely large glands (<150 g), HoLEP is a very efficacious endoscopic alternative to open prostatectomy and has proven long-term results over more than a decade. Bipolar TURP and PVP are attractive with a minimal learning curves and equivalent short term durability. Surgical management of large prostate should be individualized based upon patient's comorbidities and surgeon's expertise.
Url:
DOI: 10.4103/0970-1591.117288
PubMed: 24082445
PubMed Central: 3783704
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<front><div type="abstract" xml:lang="en"><p>Transurethral resection of prostate (TURP) has long been the most commonly performed surgical procedure for the management of benign prostate enlargement (BPE), but has several associated limitations. Over the years, laser techniques have developed as major contenders as alternative therapies for BPE. However, simultaneously, TURP has also flourished and with relatively recent development of resection in saline (bipolar TURP), the tussle between laser techniques and TURP has further gained momentum. A systematic search was performed on Medline using the various Medical subject headings related to the surgical management of BPE including TURP, bipolar, lasers, holmium laser enucleation of prostate (HoLEP), photo-selective vaporization of prostate (PVP), etc., All articles types including meta-analysis randomized controlled trials, review articles, guidelines from various urological associations, single center studies from 2002 onward were considered for review. Bipolar TURP, HoLEP, and PVP provide equivalent outcomes for large prostate adenoma (<60 g). For extremely large glands (<150 g), HoLEP is a very efficacious endoscopic alternative to open prostatectomy and has proven long-term results over more than a decade. Bipolar TURP and PVP are attractive with a minimal learning curves and equivalent short term durability. Surgical management of large prostate should be individualized based upon patient's comorbidities and surgeon's expertise.</p>
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<pmc article-type="meeting-report"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Indian J Urol</journal-id>
<journal-id journal-id-type="iso-abbrev">Indian J Urol</journal-id>
<journal-id journal-id-type="publisher-id">IJU</journal-id>
<journal-title-group><journal-title>Indian Journal of Urology : IJU : Journal of the Urological Society of India</journal-title>
</journal-title-group>
<issn pub-type="ppub">0970-1591</issn>
<issn pub-type="epub">1998-3824</issn>
<publisher><publisher-name>Medknow Publications & Media Pvt Ltd</publisher-name>
<publisher-loc>India</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">24082445</article-id>
<article-id pub-id-type="pmc">3783704</article-id>
<article-id pub-id-type="publisher-id">IJU-29-225</article-id>
<article-id pub-id-type="doi">10.4103/0970-1591.117288</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Symposium</subject>
</subj-group>
</article-categories>
<title-group><article-title>Management of large prostatic adenoma: Lasers versus bipolar transurethral resection of prostate</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Gupta</surname>
<given-names>Narmada P</given-names>
</name>
<xref ref-type="aff" rid="aff1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Nayyar</surname>
<given-names>Rishi</given-names>
</name>
<xref ref-type="aff" rid="aff2">1</xref>
<xref ref-type="corresp" rid="cor1"></xref>
</contrib>
</contrib-group>
<aff id="aff1">Department of Urology, Medanta Institute of Kidney and Urology, Medanta - The Medicity, Gurgaon, Delhi, India</aff>
<aff id="aff2"><label>1</label>
Department of Urology, Dr. RML Hospital and PGIMER, New Delhi, India</aff>
<author-notes><corresp id="cor1"><bold>For correspondence:</bold>
Dr. Rishi Nayyar, Department of Urology, RML Hospital and PGIMER, New Delhi - 110 001, India. E-mail: <email xlink:href="nayyarrishi@gmail.com">nayyarrishi@gmail.com</email>
</corresp>
</author-notes>
<pub-date pub-type="ppub"><season>Jul-Sep</season>
<year>2013</year>
</pub-date>
<volume>29</volume>
<issue>3</issue>
<fpage>225</fpage>
<lpage>235</lpage>
<permissions><copyright-statement>Copyright: © Indian Journal of Urology</copyright-statement>
<copyright-year>2013</copyright-year>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc-sa/3.0"><license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<abstract><p>Transurethral resection of prostate (TURP) has long been the most commonly performed surgical procedure for the management of benign prostate enlargement (BPE), but has several associated limitations. Over the years, laser techniques have developed as major contenders as alternative therapies for BPE. However, simultaneously, TURP has also flourished and with relatively recent development of resection in saline (bipolar TURP), the tussle between laser techniques and TURP has further gained momentum. A systematic search was performed on Medline using the various Medical subject headings related to the surgical management of BPE including TURP, bipolar, lasers, holmium laser enucleation of prostate (HoLEP), photo-selective vaporization of prostate (PVP), etc., All articles types including meta-analysis randomized controlled trials, review articles, guidelines from various urological associations, single center studies from 2002 onward were considered for review. Bipolar TURP, HoLEP, and PVP provide equivalent outcomes for large prostate adenoma (<60 g). For extremely large glands (<150 g), HoLEP is a very efficacious endoscopic alternative to open prostatectomy and has proven long-term results over more than a decade. Bipolar TURP and PVP are attractive with a minimal learning curves and equivalent short term durability. Surgical management of large prostate should be individualized based upon patient's comorbidities and surgeon's expertise.</p>
</abstract>
<kwd-group><kwd>Benign prostate enlargement</kwd>
<kwd>bipolar</kwd>
<kwd>holmium laser enucleation of prostate</kwd>
<kwd>laser</kwd>
<kwd>photo-selective vaporization of prostate</kwd>
<kwd>transurethral resection of prostate</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
</record>
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