The endoscopic resection in two surgery steps - therapeutic solution in peculiar BPH cases

Abstract

Objective: The two steps endoscopic resection for BPH can be from the beginning indicated (great adenomas) or imposed during resection (intra-operative or anaesthetic complications or incidents). Material and Methods: Out of 7500 TUR-P done during 1983 - 2000 in our center, from which 57 cases of prostatic adenomas were endoscopic resected in two steps (at maximum of 7 days from the first intervention). This kind of surgical intervention was settled from the beginning in 5 cases (10,6%>), and for the rest it was imposed by the intra-operative complications. Results: The TUR-P intervention in two steps was performed in 5 cases with great adenoma where classical operation was not indicated due to associated organics problems (especially severe respiratory dysfunction, marked obesity, etc), when was respected one lobe and after around one week the operation was ended. For the rest of 52 cases the endoscopic resection had to be stopped because of intra-operative massive bleeding (12 cases), trigonal submination (5 cases), anaesthetical accidents (17 cases) and cardio-vascular balance accidents (18 cases). Conclusions: The endoscopic resection in two steps solved in better conditions patients with prostatic adenomas comparative to an incomplete resection, which would have stressed the symptomatology and complications of those patients.