Radical Transurethral Resection of the Prostate: A Possible Radical Procedure Against Localized Prostate Cancer with Almost No Postoperative Urinary Incontinence

Aim. To assess the rate and reasons for urological complications of subtotal transurethral resection of prostate performed prior to high-intensity focused ultrasound. Methods. The study included 101 patients with localized prostate cancer treated by high-intensity focused ultrasound. Two groups of patients were allocated. Patients, who did not undergo transurethral resection of prostate prior to high-intensity focused ultrasound, were included in group 1 (21 patients). Second group included patients in whom subtotal transurethral resection of prostate was performed prior to high-intensity focused ultrasound to decrease anteroposterior diameter of the prostate and urethral canal compression. The impact of treatment tactics on complications rate was defined by factor analysis. Results. Early post-surgical complications were rare, complications mostly occurred at late period. The most frequent, severe and poorly controlled complications included urinary incontinence [58 (57.8%) patients] and urethral stricture [30 (29.7%) patients]. Most of complications were registered in second group of patients compared to the first: first group - in 10 (12.5%) of cases, second group - in 77 (95.0%) of cases. Urinary incontinence was observed in 7 (33.3%) patients and urethral stricture - in 4 (19%) of patients in the first group; in 51 (63.7%) and 26 (32.5%) patients in the second group respectively; the difference was statistically significant. Conclusion. Comparative analysis of different approaches to treatment of localized prostate cancer using high-intensity focused ultrasound revealed that subtotal transurethral resection of prostate performed prior to high-intensity focused ultrasound significantly increases the risk for developing urinary incontinence and urethral strictures.

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THE RISK OF URINARY INCONTINENCE AFTER FIDUCIAL BASED IMAGE-GUIDED HIGH DOSE INTENSITY MODULATED RADIATION THERAPY FOR LOCALIZED PROSTATE CANCER

The Journal of Urology ◽

10.1016/s0022-5347(09)62123-6 ◽

2009 ◽

Vol 181 (4S) ◽

pp. 762-762

Author(s):

Edward Obedian ◽

Carl A Olsson ◽

Deepak A Kapoor ◽

John Keane ◽

Shawn H Zimberg

Keyword(s):

Prostate Cancer ◽

Radiation Therapy ◽

Urinary Incontinence ◽

Intensity Modulated Radiation Therapy ◽

Dose Intensity ◽

Localized Prostate Cancer ◽

High Dose ◽

Image Guided ◽

Intensity Modulated ◽

High Dose Intensity

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A systems-based modelling approach using transurethral resection of the prostate (TURP) specimens yielded incremental prognostic significance to Gleason when predicting long-term outcome in men with localized prostate cancer

BJU International ◽

10.1111/j.1464-410x.2011.10316.x ◽

2011 ◽

Vol 109 (2) ◽

pp. 207-213 ◽

Cited By ~ 4

Author(s):

Michael J. Donovan ◽

Faisal M. Khan ◽

Valentina Bayer-Zubek ◽

Douglas Powell ◽

Jose Costa ◽

...

Keyword(s):

Prostate Cancer ◽

Transurethral Resection ◽

Prognostic Significance ◽

Localized Prostate Cancer ◽

Term Outcome ◽

Long Term Outcome ◽

Modelling Approach

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Retrospective Study of Laparoscopic Radical Prostatectomy for Localized Prostate Cancer after Transurethral Resection of the Prostate Compared with Retropubic Radical Prostatectomy at the Same Institution

Journal of Nippon Medical School ◽

10.1272/jnms.79.416 ◽

2012 ◽

Vol 79 (6) ◽

pp. 416-421

Author(s):

Yasutomo Suzuki ◽

Ichiro Matsuzawa ◽

Tsutomu Hamasaki ◽

Go Kimura ◽

Yukihiro Kondo

Keyword(s):

Prostate Cancer ◽

Retrospective Study ◽

Radical Prostatectomy ◽

Transurethral Resection ◽

Laparoscopic Radical Prostatectomy ◽

Localized Prostate Cancer ◽

Retropubic Radical Prostatectomy

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Urinary Incontinence following Treatment of Localized Prostate Cancer

Cancer Control ◽

10.1177/107327480100800608 ◽

2001 ◽

Vol 8 (6) ◽

pp. 532-539 ◽

Cited By ~ 39

Author(s):

Philippe Grise ◽

Scott Thurman

Keyword(s):

Prostate Cancer ◽

Urinary Incontinence ◽

Localized Prostate Cancer

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Long-Term Clinical Outcomes of Radical Prostatectomy versus Watchful Waiting in Localized Prostate Cancer Patients: A Systematic Review and Meta-Analysis

Iranian Journal of Public Health ◽

10.18502/ijph.v48i4.978 ◽

2019 ◽

Author(s):

Mojtaba NOUHI ◽

Seyed Masood MOUSAVI ◽

Alireza OLYAEEMANESH ◽

Nasser SHAKSISALIM ◽

Ali AKBARI SARI

Keyword(s):

Prostate Cancer ◽

Urinary Incontinence ◽

Radical Prostatectomy ◽

Clinical Outcomes ◽

Watchful Waiting ◽

Localized Prostate Cancer ◽

Controlled Trials ◽

All Cause Mortality

Background: The present study aimed to compare the long-term clinical and functional outcomes of patients with clinically localized prostate cancer treated with radical prostatectomy compared to the watchful waiting. Methods: PubMed, Cochrane Central Register of Controlled Trials and reference lists of relevant marker studies were scrutinized from inception to Jan 2018. Two reviewers conducted data abstraction and quality assessment of included trials independently. Quality of included studies were assessed by using Cochrane checklist. Inverse-variance and Mantel-Haenszel estimates under random effects model were used to pool results as relative risks with 95% confidence interval. Heterogeneity was assessed by using I2. Results: Three randomized controlled trials with 1568 participants were included. Compared to watchful waiting, radical prostatectomy had no significant effect on all-cause mortality at 12-year follow-up. However, radical prostatectomy had significant effect on reducing prostate-cause mortality at 12-year follow-up. We found significant lower prostate-cause mortality in patients with PSA>10 and GS≥7 scores who had undergone radical prostatectomy compared with patients in watchful waiting group. In addition, younger patients undergoing surgery developed lower distant metastases rate compared to another approach. Watchful waiting had a significant effect on erectile and urinary incontinence during 2 years. Conclusion: There was no significant difference between radical prostatectomy and watchful waiting on all-cause mortality. However, the radical prostatectomy was associated with statistically lower prostate-cause mortality and metastases rates. Compared with older men, younger men experienced better clinical outcomes. Moreover, watchful waiting had better effect on reducing erectile dysfunction and urinary incontinence among patients during 2 years compared to radical prostatectomy.

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Can We Consider the Possibility of Transurethral Resection of the Prostate (TURP) Becoming Another Gateway to the Focal Therapy of Localized Prostate Cancer?

Journal of Endoluminal Endourology ◽

10.22374/jeleu.v3i2.87 ◽

2020 ◽

Vol 3 (2) ◽

pp. e22-e30

Author(s):

Masaru Morita ◽

Akira Morita ◽

Takeshi Matsuura

Keyword(s):

Prostate Cancer ◽

Transurethral Resection ◽

Risk Group ◽

Radical Resection ◽

Focal Therapy ◽

Localized Prostate Cancer ◽

Transurethral Resection Of Prostate ◽

Low Grade ◽

Psa Testing ◽

Number Of Patients

Background and ObjectivesMinimally invasive methods are expected to avoid the risk of overtreatment and overtreatment of radical therapy to manage the increased number of patients with low-volume, low-grade localized prostate cancer. Based on our experience of radical transurethral resection of prostate cancer (TURPCa) as a radical treatment, we studied the efficacy and safety of focal TURPCa as a focal therapy for patients with localized prostate cancer. Materials and MethodsWe performed focal TURPCa in 49 patients during the period from July 2007 to August 2016 and followed them with prostate-specific antigen (PSA) testing for the mean period of 68.0 months. We selected the patient as a candidate for the study if the biopsy revealed that cancer foci were limited in one lobe, or the foci were several or less even found in both lobes. Standard TURP was followed by further resection and fulguration of the peripheral zone where cancer was considered to exist. We selected one of our three methods of focal TURPCa as follows: one lobe radical TURPCa, radical resection of the affected lobe with unaffected lobe being resected less vigorously; nerve-sparing radical TURPCa, radical resection of both lobes except for the posterolateral part of the prostate; target radical TURPCa, radical resection of the cancer focus and the surrounding prostate when the target is suggested single. ResultsTwelve patients were in the low-risk group (D’Amico), 29 in the intermediate-risk group, and 8 in the high-risk group. Pathological stages were as follows: pT0, three cases; pT2a-b, 17 cases; pT2c, 29 cases. The preoperative PSA of 6.15±2.73 ng/mL (mean±SD) dropped to 0.172±0.283 ng/mL postoperatively. PSA failure occurred in only two patients (4.1%). Incontinence did not develop and erectile function was preserved in eight (44.4%) of the 18 potent patients. The most frequent complication was bladder neck contracture (20.4%). Other complications included acute epididymitis (8.1%), bladder tamponade (2.0%). No patients died of prostate cancer. ConclusionsThough the final assessment of efficacy will require long-term follow-up results with more cases, we may think focal TURPCa can be another treatment option as a focal therapy for localized prostate cancer.

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