Post-prostatectomy incontinence: multimodal modern-day management

Comparison of the Transurethral Resection of the Prostate by Traditional Versus Preserved Urethral Mucosa of the Prostatic Apex

Background: Benign prostatic hyperplasia (BPH) is a common disease in elderly men. Transurethral resection of the prostate (TURP) is still the standard treatment for BPH. However, postoperative urinary incontinence (UI) is still one of the complications. Objective: This study aims to evaluate the clinical efficacy and safety of the TURP by traditional compared with preserved urethral mucosa of the prostatic apex (PUMPA). Materials and Methods: From July 2015 to June 2016, 80 patients with TURP were included and divided into the two groups: traditional nonpreserved urethral mucosa group (TURP group, n = 40) and the PUMPA group (PUMPA-TURP group, n = 40). This study identified the apex of the prostate and determined the cut position of mucosa. Then, we separated the preserved urethral mucosa, excised the hyperplastic prostate tissue, and trimmed the preserved urethral mucosa. Results: The rate of UI after PUMPA-TURP was significantly lower than that traditional TURP (0% vs 22.5%). The operative time was significantly shorter in the PUMPA-TURP group than traditional TURP group (50 ± 16.5 minutes vs 65 ± 18.5 minutes). The intraoperative bleeding loss was lower in the PUMPA-TURP group than traditional TURP group (280 ± 33 mL vs 190 ± 35 mL). International prostate symptom score, quality of life (QoL), and peak uroflowmetry data (Qmax) were similar between two groups. Conclusions: When compared with traditional TURP, PUMPA-TURP can reduce the occurrence of UI and intraoperative blood loss. Besides, PUMPA-TURP could shorten the operative time.