Impact of Changing Trends in Medical Therapy on Transurethral Resection of the Prostate: Two Decades of Change in China

ObjectiveTo retrospectively assess that over the 2 decades, whether medical therapy has changed indications, patient characteristics, and outcomes in men undergoing transurethral resection of the prostate (1992-2013).MethodsAt our institution, medical history of all patients undergoing surgery before 1998, between 2001 and 2003, and between 2011 and 2013 was reviewed. Patient demographics, preoperative clinical profile, clinical management, and operative complications were assessed.ResultsA total of 1157 patients were enrolled in the study. Mean ages of patients increased from 67.0 to 70.4 years old over the past 2 decades. Furthermore, comorbidities increased significantly as well. Although prostate size and weight of resected tissue increased from 57.3 to 92.3 g and from 24.3 to 36.6 g, the surgical time decreased from 78.21 to 72.29 minutes. From 2011 to 2013, patients undergoing surgery had their catheters remove earlier (from 5.7 to 4.5 days), whose postoperative days in hospital were shorter (from 9.3 to 4.4 days). Although operative complications decreased from 12.3% to 5.7%, especially bleeding, re-operation due to bleeding increased from 0.4% to 2.7%. Moreover, no statistical difference was observed in operative complications between patients with medical therapy and those without medical therapy.ConclusionThe increasing application of medical therapy resulted in surgical interventions delay. The prostate size was significantly greater, as was the weight of resected tissue. Although patients with medication were older with more comorbidities and larger prostates, surgical technique advancements have benefited them and transurethral resection of the prostate is still considered as a safe and recommendable surgical treatment.