Incidence of urethral stricture after bipolar transurethral resection of the prostate using TURis: Results from a randomised trial

Kazumasa Komura, Teruo Inamoto, Tomoaki Takai, Taizo Uchimoto, Kenkichi Saito, Naoki Tanda, Koichiro Minami, Rintaro Oide, Hirofumi Uehara, Kiyoshi Takahara, Hajime Hirano, Hayahito Nomi, Satoshi Kiyama, Toshikazu Watsuji, Haruhito Azuma

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

ObjectivesTo assess whether bipolar transurethral resection of the prostate (B-TURP) using the TURis® system has a similar level of efficacy and safety to that of the traditional monopolar transurethral resection of the prostate (M-TURP), and to evaluate the impact of the TURis system on postoperative urethral stricture rates over a 36-month follow-up period. Patients and Methods A total of 136 patients with benign prostatic obstruction were randomised to undergo either B-TURP using the TURis system or conventional M-TURP, and were regularly followed for 36 months after surgery. The primary endpoint was safety, which included the long-term complication rates of postoperative urethral stricture. The secondary endpoint was the follow-up measurement of efficacy. Results In peri-operative findings, no patient in either treatment group presented with transurethral resection syndrome, and the decline in levels of haemoglobin and hematocrit were similar. The mean operation time was significantly extended in the TURis treatment group compared with the M-TURP group (79.5 vs 68.6 min; P = 0.032) and postoperative clot retention was more likely to be seen after M-TURP (P = 0.044). Similar efficacy findings were maintained throughout 36 months, but a significant difference in postoperative urethral stricture rates between groups was detected (6.6% in M-TURP vs 19.0% in TURis; P = 0.022). After stratifying patients according to prostate volume, there was no significant difference between the two treatment groups with regard to urethral stricture rates in patients with a prostate volume ≤ 70 mL (3.8% in M-TURP vs 3.8% in TURis), but in the TURis group there was a significantly higher urethral stricture rate compared with the M-TURP group in patients with a prostate volume >70 mL (20% in TURis vs 2.2% in M-TURP; P = 0.012). Furthermore, the mean operation time for TURis was significantly longer than for M-TURP for the subgroup of patients with a prostate volume > 70 mL (99.6 vs 77.2 min; P = 0.011), but not for the subgroup of patients with a prostate volume ≤ 70 mL. Conclusion The TURis system seems to be as efficacious and safe as conventional M-TURP except that there was a higher incidence of urethral stricture in patients with larger preoperative prostate volumes.

Original languageEnglish
Pages (from-to)644-652
Number of pages9
JournalBJU International
Volume115
Issue number4
DOIs
Publication statusPublished - 01-04-2015
Externally publishedYes

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Urethral Stricture
Transurethral Resection of Prostate
Incidence
Prostate
Safety
Hematocrit
Hemoglobins
Therapeutics

All Science Journal Classification (ASJC) codes

  • Urology

Cite this

Komura, Kazumasa ; Inamoto, Teruo ; Takai, Tomoaki ; Uchimoto, Taizo ; Saito, Kenkichi ; Tanda, Naoki ; Minami, Koichiro ; Oide, Rintaro ; Uehara, Hirofumi ; Takahara, Kiyoshi ; Hirano, Hajime ; Nomi, Hayahito ; Kiyama, Satoshi ; Watsuji, Toshikazu ; Azuma, Haruhito. / Incidence of urethral stricture after bipolar transurethral resection of the prostate using TURis : Results from a randomised trial. In: BJU International. 2015 ; Vol. 115, No. 4. pp. 644-652.
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title = "Incidence of urethral stricture after bipolar transurethral resection of the prostate using TURis: Results from a randomised trial",
abstract = "ObjectivesTo assess whether bipolar transurethral resection of the prostate (B-TURP) using the TURis{\circledR} system has a similar level of efficacy and safety to that of the traditional monopolar transurethral resection of the prostate (M-TURP), and to evaluate the impact of the TURis system on postoperative urethral stricture rates over a 36-month follow-up period. Patients and Methods A total of 136 patients with benign prostatic obstruction were randomised to undergo either B-TURP using the TURis system or conventional M-TURP, and were regularly followed for 36 months after surgery. The primary endpoint was safety, which included the long-term complication rates of postoperative urethral stricture. The secondary endpoint was the follow-up measurement of efficacy. Results In peri-operative findings, no patient in either treatment group presented with transurethral resection syndrome, and the decline in levels of haemoglobin and hematocrit were similar. The mean operation time was significantly extended in the TURis treatment group compared with the M-TURP group (79.5 vs 68.6 min; P = 0.032) and postoperative clot retention was more likely to be seen after M-TURP (P = 0.044). Similar efficacy findings were maintained throughout 36 months, but a significant difference in postoperative urethral stricture rates between groups was detected (6.6{\%} in M-TURP vs 19.0{\%} in TURis; P = 0.022). After stratifying patients according to prostate volume, there was no significant difference between the two treatment groups with regard to urethral stricture rates in patients with a prostate volume ≤ 70 mL (3.8{\%} in M-TURP vs 3.8{\%} in TURis), but in the TURis group there was a significantly higher urethral stricture rate compared with the M-TURP group in patients with a prostate volume >70 mL (20{\%} in TURis vs 2.2{\%} in M-TURP; P = 0.012). Furthermore, the mean operation time for TURis was significantly longer than for M-TURP for the subgroup of patients with a prostate volume > 70 mL (99.6 vs 77.2 min; P = 0.011), but not for the subgroup of patients with a prostate volume ≤ 70 mL. Conclusion The TURis system seems to be as efficacious and safe as conventional M-TURP except that there was a higher incidence of urethral stricture in patients with larger preoperative prostate volumes.",
author = "Kazumasa Komura and Teruo Inamoto and Tomoaki Takai and Taizo Uchimoto and Kenkichi Saito and Naoki Tanda and Koichiro Minami and Rintaro Oide and Hirofumi Uehara and Kiyoshi Takahara and Hajime Hirano and Hayahito Nomi and Satoshi Kiyama and Toshikazu Watsuji and Haruhito Azuma",
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volume = "115",
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Komura, K, Inamoto, T, Takai, T, Uchimoto, T, Saito, K, Tanda, N, Minami, K, Oide, R, Uehara, H, Takahara, K, Hirano, H, Nomi, H, Kiyama, S, Watsuji, T & Azuma, H 2015, 'Incidence of urethral stricture after bipolar transurethral resection of the prostate using TURis: Results from a randomised trial', BJU International, vol. 115, no. 4, pp. 644-652. https://doi.org/10.1111/bju.12831

Incidence of urethral stricture after bipolar transurethral resection of the prostate using TURis : Results from a randomised trial. / Komura, Kazumasa; Inamoto, Teruo; Takai, Tomoaki; Uchimoto, Taizo; Saito, Kenkichi; Tanda, Naoki; Minami, Koichiro; Oide, Rintaro; Uehara, Hirofumi; Takahara, Kiyoshi; Hirano, Hajime; Nomi, Hayahito; Kiyama, Satoshi; Watsuji, Toshikazu; Azuma, Haruhito.

In: BJU International, Vol. 115, No. 4, 01.04.2015, p. 644-652.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Incidence of urethral stricture after bipolar transurethral resection of the prostate using TURis

T2 - Results from a randomised trial

AU - Komura, Kazumasa

AU - Inamoto, Teruo

AU - Takai, Tomoaki

AU - Uchimoto, Taizo

AU - Saito, Kenkichi

AU - Tanda, Naoki

AU - Minami, Koichiro

AU - Oide, Rintaro

AU - Uehara, Hirofumi

AU - Takahara, Kiyoshi

AU - Hirano, Hajime

AU - Nomi, Hayahito

AU - Kiyama, Satoshi

AU - Watsuji, Toshikazu

AU - Azuma, Haruhito

PY - 2015/4/1

Y1 - 2015/4/1

N2 - ObjectivesTo assess whether bipolar transurethral resection of the prostate (B-TURP) using the TURis® system has a similar level of efficacy and safety to that of the traditional monopolar transurethral resection of the prostate (M-TURP), and to evaluate the impact of the TURis system on postoperative urethral stricture rates over a 36-month follow-up period. Patients and Methods A total of 136 patients with benign prostatic obstruction were randomised to undergo either B-TURP using the TURis system or conventional M-TURP, and were regularly followed for 36 months after surgery. The primary endpoint was safety, which included the long-term complication rates of postoperative urethral stricture. The secondary endpoint was the follow-up measurement of efficacy. Results In peri-operative findings, no patient in either treatment group presented with transurethral resection syndrome, and the decline in levels of haemoglobin and hematocrit were similar. The mean operation time was significantly extended in the TURis treatment group compared with the M-TURP group (79.5 vs 68.6 min; P = 0.032) and postoperative clot retention was more likely to be seen after M-TURP (P = 0.044). Similar efficacy findings were maintained throughout 36 months, but a significant difference in postoperative urethral stricture rates between groups was detected (6.6% in M-TURP vs 19.0% in TURis; P = 0.022). After stratifying patients according to prostate volume, there was no significant difference between the two treatment groups with regard to urethral stricture rates in patients with a prostate volume ≤ 70 mL (3.8% in M-TURP vs 3.8% in TURis), but in the TURis group there was a significantly higher urethral stricture rate compared with the M-TURP group in patients with a prostate volume >70 mL (20% in TURis vs 2.2% in M-TURP; P = 0.012). Furthermore, the mean operation time for TURis was significantly longer than for M-TURP for the subgroup of patients with a prostate volume > 70 mL (99.6 vs 77.2 min; P = 0.011), but not for the subgroup of patients with a prostate volume ≤ 70 mL. Conclusion The TURis system seems to be as efficacious and safe as conventional M-TURP except that there was a higher incidence of urethral stricture in patients with larger preoperative prostate volumes.

AB - ObjectivesTo assess whether bipolar transurethral resection of the prostate (B-TURP) using the TURis® system has a similar level of efficacy and safety to that of the traditional monopolar transurethral resection of the prostate (M-TURP), and to evaluate the impact of the TURis system on postoperative urethral stricture rates over a 36-month follow-up period. Patients and Methods A total of 136 patients with benign prostatic obstruction were randomised to undergo either B-TURP using the TURis system or conventional M-TURP, and were regularly followed for 36 months after surgery. The primary endpoint was safety, which included the long-term complication rates of postoperative urethral stricture. The secondary endpoint was the follow-up measurement of efficacy. Results In peri-operative findings, no patient in either treatment group presented with transurethral resection syndrome, and the decline in levels of haemoglobin and hematocrit were similar. The mean operation time was significantly extended in the TURis treatment group compared with the M-TURP group (79.5 vs 68.6 min; P = 0.032) and postoperative clot retention was more likely to be seen after M-TURP (P = 0.044). Similar efficacy findings were maintained throughout 36 months, but a significant difference in postoperative urethral stricture rates between groups was detected (6.6% in M-TURP vs 19.0% in TURis; P = 0.022). After stratifying patients according to prostate volume, there was no significant difference between the two treatment groups with regard to urethral stricture rates in patients with a prostate volume ≤ 70 mL (3.8% in M-TURP vs 3.8% in TURis), but in the TURis group there was a significantly higher urethral stricture rate compared with the M-TURP group in patients with a prostate volume >70 mL (20% in TURis vs 2.2% in M-TURP; P = 0.012). Furthermore, the mean operation time for TURis was significantly longer than for M-TURP for the subgroup of patients with a prostate volume > 70 mL (99.6 vs 77.2 min; P = 0.011), but not for the subgroup of patients with a prostate volume ≤ 70 mL. Conclusion The TURis system seems to be as efficacious and safe as conventional M-TURP except that there was a higher incidence of urethral stricture in patients with larger preoperative prostate volumes.

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