For many years, the most common surgery for an enlarged prostate has been TURP— transurethral resection of the prostate—but a number of newer procedures have emerged over the past decade. Among the alternatives to TURP are TUNA (transurethral needle ablation), TUMT (transurethral microwave therapy), transurethral vaporization of the prostate (TVP), and laser coagulation (interstitial laser therapy, ILT).
During a recent comparison of surgeries for enlarged prostate (BPH, benign prostatic hyperplasia), researchers found that the most common surgery for BPH was associated with a few more complications, but that the need for reoperation was 50% or greater when compared with newer minimally invasive surgical procedures.
Now that men with BPH have several surgical options from which to choose, a comparison of the procedures and their associated complications and need for reoperation would provide valuable data for patients and their physicians. Results of a study presented at the American Urological Association meeting offer that information.
Researchers reviewed data on 624,319 men who underwent BPH procedures during 2001 to 2007. They found that:
TURP accounted for 51.8% of all the procedures, although its portion of the total number of surgeries began to decline toward the end of the review period
Urethral stricture and bladder neck contracture, the two most common complications, occurred more often after TURP than after TUNA, TUMT, TVP, or interstitial laser therapy
Urethral stricture occurred in 4.4% of all BPH surgeries and was highest after TURP (5.7%) and lowest after TUMT (2.3%)
Reoperation was necessary for 8.3% of TURP patients compared with 15.8% of TVP patients, 22.4% of interstitial laser therapy patients, 21.2% of TUNA patients, and 25.8% of TUMT patients
The chances of repeat surgery after laser therapy or TUMT was 2.1 to 3.5 times higher than after TURP.