Simultaneous transurethral resection of the prostate and cystolithotripsy: A urological dilemma examined

Authors

  • Sander Mekke Haga teaching hospital
  • Hossain Roshani Haga Teaching Hospital
  • Paul van Zanten Renier de Graaf Gasthuis
  • Lorena Grondhuis Palacios Haaglanden Medisch Centrum
  • Joost Egberts Leiden University Medical Centre
  • Nora Hendriks Alrijne Health Care Group
  • Mischa Wijffelman Alrijne Health Care Group
  • Willemijn Zonneveld Leiden University Medical Center
  • Bob Merks Haaglanden Medisch Centrum
  • Sarah van Loopik Reinier de Graaf Gasthuis
  • Tim Buddingh Haga Teaching Hospital

DOI:

https://doi.org/10.5489/cuaj.6743

Keywords:

bladder stone, bladder calculus, cystolithotripsy, TURP, bladder outlet obstruction

Abstract

Introduction: Controversy exists over whether transurethral resection of the prostate (TURP) in men with bladder stones prevents recurrence of stone formation and facilitates stone discharge. We sought to evaluate whether TURP in patients who underwent cystolithotripsy led to a lower recurrence of bladder stones for which a re-cystolithotripsy was necessary.

Methods: Patients (n=127) who underwent transurethral cystolithotripsy with (n=38) or without simultaneous TURP (n=89) between January 2009 and December 2013 were retrospectively included in five centers in the Netherlands. Median followup was 48 months. The primary endpoint was to compare the relative risk between both groups for re-cystolithotripsy due to recurrent bladder stones. Secondary outcomes were the relative risk of urinary retention, the need for a (re-)TURP and the average time until recurrence.

Results: Patients who underwent a cystolithotripsy with a simultaneous TURP had a lower need for re-cystolithotripsy, resulting in a risk reduction of 72%. (relative risk [RR] 0.28 [0.07–1.13], p=0.06, number needed to treat [NNT]=7). The length of in hospital stay (3.4 vs. 1.6 days, p=0.04) and operative time (58 vs. 33 minutes, p<0.01) was longer when a TURP was performed. There was no significant difference in complication rate, occurrence of urinary retention, re- TURP, and re-admission. Eighty-one percent of patients who did not undergo a TURP remained free of bladder stone recurrence. Due to the retrospective nature of the study, essential data concerning prostate volume and micturition analysis was lacking.

Conclusions: A simultaneous TURP in patients who underwent a cystolithotripsy showed a trend towards a protective effect on the need for re-cystolithotripsy.

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Published

2020-12-15

How to Cite

Mekke, S., Roshani, H., van Zanten, P., Grondhuis Palacios, L., Egberts, J., Hendriks, N., Wijffelman, M., Zonneveld, W., Merks, B., van Loopik, S., & Buddingh, T. (2020). Simultaneous transurethral resection of the prostate and cystolithotripsy: A urological dilemma examined. Canadian Urological Association Journal, 15(7), E361–5. https://doi.org/10.5489/cuaj.6743

Issue

Vol. 15 No. 7 (2021): CUAJ July

Section

Original Research

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