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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
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