Outcomes of Transurethral Resection of the Prostate Using a 22F Continuous Running Irrigation System Slender Resectoscope in Patients with Benign Prostatic Hyperplasia: A Prospective Observational Study from Central India
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Abstract
Transurethral resection of the prostate (TURP) remains the gold standard surgical treatment for benign prostatic hyperplasia (BPH). Conventional larger-caliber resectoscopes, however, may contribute to urethral trauma, increased postoperative morbidity, and delayed recovery. The introduction of a slender 22F continuous running irrigation system resectoscope has been proposed to minimize instrumentation-related complications while maintaining surgical efficacy.
Aim
To evaluate the clinical outcomes, functional improvement, recovery profile, and complications associated with TURP performed using a 22F continuous running irrigation system slender resectoscope in patients with symptomatic benign prostatic hyperplasia.
Materials and Methods
This prospective observational study included 42 patients with symptomatic benign prostatic hyperplasia who underwent TURP at a tertiary care center in Central India. Patients with a prostate volume of less than 60 cc and no history of urethral stricture, previous prostate surgery, neurogenic bladder dysfunction, bladder stones, or suspected malignancy were included. Preoperative evaluation comprised the International Prostate Symptom Score (IPSS), maximum urinary flow rate (Qmax), post-void residual urine (PVR), prostate volume, and serum prostate-specific antigen (PSA). Postoperative assessment included catheter removal time, duration of hospital stay, perioperative complications, and changes in IPSS, Qmax, and PVR. Statistical analysis was performed using the Wilcoxon signed-rank test, with a p-value of <0.05 considered statistically significant.
Results
The mean age of the participants was 69.19 ± 5.55 years. The mean prostate volume was 47.67 ± 5.87 cc, while the mean serum PSA level was 2.87 ± 0.64 ng/mL. The mean IPSS significantly decreased from 16.19 ± 2.28 preoperatively to 5.67 ± 1.57 postoperatively (p < 0.001). Similarly, the mean Qmax improved from 7.96 ± 1.25 mL/s to 17.30 ± 1.57 mL/s (p < 0.001), whereas the mean PVR decreased from 140.71 ± 43.44 mL to 27.55 ± 8.87 mL (p < 0.001). The mean catheter removal time was 36.00 ± 10.17 hours, and the mean duration of hospital stay was 3.17 ± 0.54 days. Intraoperative complications occurred in 4.76% of patients, while postoperative complications occurred in 9.52%; all complications were minor and managed conservatively.
Conclusion
TURP performed using a 22F continuous running irrigation system slender resectoscope is a safe and effective surgical option for patients with symptomatic benign prostatic hyperplasia. The technique provides significant symptomatic relief and functional improvement while maintaining a low perioperative complication rate, facilitating early catheter removal, and reducing hospital stay.
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