ERECTILE DYSFUNCTION AFTER TRANSURETHRAL PROSTATE RESECTION (TURP) IN PATIENTS WITH LOWER URINARY TRACT SYMPTOMS AT KOJA HOSPITAL, JAKARTA

Objective: Aim of this study is to identify risk factors associated with erectile dysfunction in post-transurethral prostate resection (TURP) patients for the management of benign prostatic hyperplasia (BPH). Material & Methods: During 2019, 22 patients met the TURP indication criteria in the urology polyclinic of Koja Hospital for symptomatic BPH management. All patients underwent transabdominal ultrasonography to confirm prostate volume and underwent laboratory tests to measure serum prostate-specific antigen (PSA). History of comorbidities such as diabetes mellitus, cardiovascular events, and hypertension was recorded. The patient's sexual function was determined using the International Index of Erectile Function questionnaire (IIEF-5) before surgery and six months postoperatively, where erectile dysfunction was established for scores below 21. Mean comparisons were made to see if there was a significant change in IIEF score six months postoperatively. Results: There were 22 subjects as samples with a mean age of 63 ± 3.8 years, prostate volume 47.64 ± 5.5 mL and a median PSA level of 3.3 [1-47] ng/dL. The comorbidities found in the subjects were diabetes mellitus (22.7%), cardiovascular events (36.4%), and hypertension (27.3%). The mean IIEF-5 score before surgery was 14.55 ± 0.78 and was not significantly different (p= 0.225) with a reevaluation six months after surgery of 14.18 ± 0.76. Conclusion: There was no change in the severity of erectile dysfunction in patients undergoing TURP surgery.

Factor of combined pathology in geriatric patients with prostate adenoma

Samara Regional Clinical Hospital of War Veterans in the period from 2000 to 2015 examined and treated 639 elderly and senile patients with prostate adenoma, who underwent an isolated adenomectomy, transurethral prostate resection, or simultaneous surgery. Among them, 191 (29.9%) patients underwent simultanous surgery. The paper presents the nature and frequency of dominant concomitant diseases in geriatric patients with prostate adenoma in the first (2000-2006) and second (2007-2015) periods of the study. Application in the second period of the author's therapeutic and diagnostic developments, taking into account concomitant pathology, significantly affected the reduction of a number of severe intra- and postoperative complications and lethality in comparison with the first period.

Effectiveness of tolterodine in relief of postoperative symptoms related to urethral catheter in transurethral prostate resection patients: a prospective randomized trial

Background: Urethral catheterisation following surgery causes significant discomfort postoperatively. Use of muscarinic receptor antagonists for relief of these symptoms in transurethral prostate resection (TURP) patients has been studied previously. In this study it is aimed to identify efficacy of toltoredine for relief of bladder overactivity symptoms in the post-operative period following TURP.Methods: In this randomized, prospective, controlled study, results of 95 patients evaluated. Group 1(n=49) received tolterodine 4 mg/day and group 2 (n=45) received no medication. Presence and severity of symptoms together with visual pain scale (VPS) scores were recorded and compared in very early and late postoperative period (0, 4, 8, 12, 24 hours and every 24 hours thereafter). Additional analgesic requirement was also compared and adverse events were recorded.Results: Tolerodine treatment was shown to be associated with low incidence and less severity of symptoms. Symptoms were shown to be present especially in the early postoperative period. VPS scores were also shown to be less in group 1. Treatment was not cessated in any of the patients due to adverse events. Conclusions: Tolterodine 4 mg/day was shown to be effective in relief of symptoms related to urethral catheterisation in the postoperative period following TURP. Treatment was not cessated in any of the patients due to adverse events. Further prospective placebo-controlled studies are needed with tolterodine and other muscarinic receptor antagonists.

Reed Miller Nesbit: Broadening the Horizon of Genitourinary Surgery

Nesbit has made his name synonymous with transurethral prostate resection and attained eminence by popularizing his technique, although his lifetime achievements and contributions reach many aspects of genitourinary surgery and pediatric urology. We believe our history article will bring memories back to more senior urologists, allow the youngsters to recall a true innovator and versatile surgeon, and appeal to a broad audience such as the readership of Surgical Innovation Journal.