Transurethral Resection of Prostate (TURP): Surgery without Using a 3-Way Catheter

Main Article Content

Adam Jones
Syed Ali Ehsanullah
Amerdip Birring
Connor Gascoigne
Sid Singh
Andrea Ginepri
Ike Apakama

Keywords

TURP, continuous bladder irrigation, 3-way catheter

Abstract

 


Transurethral resection of the prostate (TURP) continues to be an effective intervention for certain indications; and this procedure is still one of the most commonly performed in urology. The use of a 3-way catheter with continuous bladder irrigation (CBI) post-TURP is widely practiced in a bid to prevent clot retention. We report our unique experience with the use of 2-way urethral catheters post-TURP surgery.


 


Methodology


Data was prospectively collected for 143 consecutive patients who underwent a bipolar TURP between July 2015 and October 2017. The following outcomes where measured and compared against the literature: resection time, resected weight, haemoglobin level, hospital stay, catheterization days, transfusion rate and complications.


Results


Two-way 18-French catheters were used in 132/143 (91.7%) patients. The remaining 11/143 (8.3%) patients had a 3-way 22-French catheter and CBI immediately post-TURP. There were no incidences of clot retention requiring a return to theatre. There were 2/132 (1.5%) patients requiring transfusion who received 2-way catheterization. The average resection time was 44.8 (10-100) minutes, with a mean resected weight of 22.8 (2.0-70.0) grams. Post-operatively, we found minimal drop in haemoglobin levels, with a fall of 0.7 g/dL on average, with a range of 0.1-3.4 g/dL. Mean length of stay following TURP was 1.45 days (1-18), and 101/132 (76.5%) of patients had a successful trial without catheter on the first post-operative day.


Conclusion


Our outcomes compare favorably with the published data. This study suggests it may be possible to reduce the cost and resources associated with the use of 3-way catheters and CBI post-TURP surgery by using a 2-way catheter instead. Despite this, appropriate patient selection for this novel technique needs to be adopted. Our results would suggest that patients with smaller prostates or limited resections might be suitable for a 2-way urethral catheter post-TURP.

Abstract 184 | pdf Downloads 102

References

1. Rassweiler J, Teber D, Kuntz R et al. Complications of Transurethral Resection of the Prostate (TURP) – Incidence, Management, and Prevention. Eur Assoc Urol 2006;50:969–80.
2. Ahyai S, Gilling P, Kaplan S et al. Meta-analysis of functional outcomes and complications following transurethral procedures for lower urinary tract symptoms resulting from benign prostatic enlargement. Eur Assoc Urol 2010;58:384–97.
3. Abdelrahman M, Davis N, McMahon B et al. A comparative assessment of irrigation and drainage characteristic for commercially available urethral catheters. Central Eur J Urol 2017:70:382–87.
4. BARD Medical Supplies. Homepage [Internet]. Available at: www.bardmedical.co.uk/products.
5. Kapasi F, Mufti U, Pandit A et al. Is the use of two way catheter post-TURP safe? UroToday Int J 2008;1.
6. Al-Rawashdah S, Pastore A, Salhi Y et al. Prospective randomized study comparing monopolar with bipolar transurethral resection of prostate in benign prostatic obstruction: 36 month outcomes. World J Urol 2017:35;1595–601.
7. National Institute for Health and Care Excellence; NICE guideline (NG27). Transition between inpatient hospital settings and community or care home settings for adults with social care needs. NICE guidelines 2015/16.