Electroresection and open surgery

Abstract

Transurethral resection of the prostate (TURP) is the historical gold standard therapy for lower urinary tract symptoms secondary to obstruction from benign prostatic hyperplasia (BPH). Over the last 15 years, medical therapy (alpha blockers and 5-alpha-reductase inhibitors) and the advent of office-based prostatic ablation for BPH have altered the treatment landscape of men suffering from lower urinary tract symptoms. Efficacy and morbidity of newer minimally invasive surgical therapies are often compared with traditional TURP data from the 1960s and 1970s. Technologic improvements in lighting, resectoscope design, lens crafting, anesthetic care, and surgical technique have dramatically improved the efficacy, morbidity, and mortality of the modern TURP. This review outlines the indications, technique, and outcome data of the modern TURP and its variant, the saline bipolar TURP. Current indications and outcomes of simple prostatectomy (open, laparoscopic, and robotic) are also reviewed.