PRO-TURP

Urology Arena, Berne, 6. December 2019

Räto Strebel

Kantonsspital Graubünden

Case 2

TAKE HOME

• TUR-P: still a very good option!

• Low morbidity

• Very efficient

• Cost effective

• And still great fun!

Index patient has

prostate of just 100 ml!

EAU Guidelines

are 20 ml a relevant

difference?

Technique

• Same instrument fits also bigger

size (but maybe not all sizes)

No need to buy new

instruments

Technique

Courtesy of Jan Birzele

No need to learn a new

technique

Resection weight

• No evidence for complete resection (Oelke

et al, Urologe A 2019)

• Resection /enucleation weight about 2/3

– ¾ of total volume (Zhu, Urology 2012, Ou, BJU Int

2013)

Resection of 60-75g

with bipolar technique

easy to achieve

• 1000g rule

Learning Curve

Furuya et al, Hinyokika Kiyo 2006

TUR-P Kurs Chur

TURP

Easy to learn

6. Trainingskurs inkl. Hands-on

am 12. und 13. März 2020

Sexual function

Wang et al, Andrologia 2019

TURPPreserves sexual function

Complications

Gilfrich et al, Prostate cancer prostatic dis, 2016

TURP Laser Vap LEP Open pro Total

N (%) 78192 6409 2600 8376 95577

Mortality (30d) 0.32 0.58 0.27 0.51 0.36

Transfusion

(30d)3.40 2.77 2.82 14.49 4.32

Re-Intervention

bleeding (30d)7.36 6.94 9.01 5.97 7.26

Re-Intervention

1 year8.22 12.06 6.89 5.04 8.16

Adverse events

1 year2.91 3.93 2.74 6.19 3.26

Overall compli-

cations 1 year18.10 21.48 17.98 24.42 18.88

TURP:

- 82 % of all procedures

- Low complication rate

Long term outcome after TURP

TURPExcellent long term

results

Khanna et al, J Urol, 2019

TURP: good option

• TUR-P: still an excellent option!

• Low morbidity

• Very efficient

• Cost effective

• And great fun!

TURP

a fair deal

THANKS