Introduction: Intravesical explosions are a rarely documented complication of Transurethral resection of the prostate or bladder tumor. However an intrarenal explosion during ureteroscopic fulguration was documented in 1991. We reported 3 cases of an intravesical explosion resulting in an intrapritoneal bladder rupture during Transurethral resection of prostate.

Transurethral resection of prostate (TURP) and bladder tumors is one of the most common surgeries in urology. This approach is frequently being performed in most medical centers in Iran. Several intra-operative and postoperative complications of these surgeries have been reported in literature; but, one of the most uncommon complications of this technique is intravesical explosion during the surgery. Few cases of this complication have been reported.(1-3) We report 3 cases of intravesical explosion during TURP in patients with benign prostatic hyperplasia (BPH) and discuss its mechanism and the possible preventive measures.  sensed in the suprapubic area. In 2 patients, the explosion was not accompanied by any significant complications, but in 1, the bladder was ruptured in the dome region. After the explosion, the returned amount of washing liquid decreased. On cystoscopy, a rupture was noted in the bladder dome, from which the intestinal loops were seen. The patient was secured in a position suitable for achieving a median suprapubic incision. On laparotomy, we noticed a 3- to 4-cm rupture in the bladder dome. The remained liquid was immediately evacuated and the rupture was repaired in 2 layers. A urethral catheter was inserted, and after 1 week, the patient was discharged without any complications.    

Purpose: To compare the long-term (two-year) efficacy between Transurethral resection of the prostate (TURP) after prostatic artery embolization (PAE) and TURP only for patients with giant (>100 mL) benign prostatic hyperplasia. Materials and Methods: We retrospectively analyzed data from 61 and 150 patients with giant benign prostatic hyperplasia treated with PAE+TURP or TURP alone, respectively, from January 2015 to March 2020. We compared index changes before and after surgery. Results: The operative time, intraoperative blood loss, postoperative bladder irrigation time, and catheter retention time in the PAE+TURP group were lower than those of the TURP group, while the speed of resection of the lesion and hospitalization costs were more significant (P < 0. 05). International prostate symptom score (IPSS), quality of life (QoL), prostate volume, maximum urinary flow rate, detrusor pressure of maximum urinary flow rate, prostate-specific antigen, and urodynamic obstruction were better in the PAE+TURP group than the TURP group at 24 months (P < 0. 05). Regarding IPSS and QoL scores at 24 months postoperatively compared with the preoperative period, the PAE+TURP group was better than the TURP group in terms of the storage period, voiding period, and QoL (P < 0. 05). The distribution of postoperative adverse event severity classes was comparable between the groups (P = 0. 984). Conclusion: In contrast to TURP alone, PAE + TURP is more expensive but provides better postoperative outcomes,there is no significant difference in terms of the severity grade distribution of postoperative complications

As men age, a condition known as benign prostatic hyperplasia (BPH), or enlargement of the prostate gland, becomes more prevalent. The technique of Transurethral incision of the prostate (TUIP) involves splitting the bladder outlet to relieve inferior urinary tract symptoms related to BPH with no need to remove tissues. Likewise, the surgery to remove portions of the prostate gland through the penis is known as a Transurethral resection of the prostate (TURP). No cuts are required. By inserting a tool via the urethra and into the penis, the surgeon can access the prostate. The primary objective of the current study is to assess and compare the results of each procedure in a case reference study using a sample of Iraqi patients who had surgery to treat BPH. A total of 78 males with symptomatic BPH participated in this study, 31 of whom underwent TUIP, and the rest got TURP. The main outcomes to be evaluated were the periods of operation, hospital admission, catheterization, the international prostate symptom score (IPSS), the Q max, the post-voiding residual volume, and the ejaculation preservation. The mean durations of operation, hospital stay, and catheterization was significantly shorter in TUIP patients in comparison with TURP patients (P<0.05). The frequency of patients with preserved ejaculation was significantly more in TUIP patients compared with TURP patients (64.5 % vs. 37.0%) (P<0.018). TUIP was significantly better compared with TURP concerning the shorter durations of operation, hospital stays, catheterization, and preservation of ejaculation in optimally selected patients.

Introduction: The aim of this study was to investigate low-dose intrathecal meperidine for prevention or alleviation of shivering after induction of spinal anesthesia for Transurethral resection of the prostate (TURP).Materials and Methods: In a randomized controlled trial, 80 patients scheduled for TURP under spinal anesthesia were assigned into two groups of case and control. Spinal anesthesia was performed using 75 mg of hyperbaric lidocaine 5% plus meperidine, 15 mg, in the patients of the case group and the same dose of lidocaine plus normal saline in the patients of the control group. Shivering episodes were recorded during the operation and in the recovery room. Data on systolic blood pressure, heart rate, arterial oxygen saturation, and body temperature were collected before the induction of anesthesia; 5, 15, and 30 minutes after the induction; and in the recovery room.Results: Maximum level of sensory block was similar in the patients of the case and control groups. Shivering was not seen in the patients who received meperidine, while in the control group, 11 (27.5%) experienced some degrees of shivering (P = .001). Blood pressure, body temperature, and arterial oxygen saturation did not have a clinically significant change and they were not different between the two groups. Side effects of opioids were unremarkable.Conclusion: Low-dose intrathecal meperidine is effective and safe in reducing the incidence of shivering associated with spinal anesthesia for TURP.

Background and purpose: Enlarged prostate places pressure on the urethra and causes urinary problems, the treatment of which is medication and surgery. The effect of Transurethral resection of the prostate (TURP) on sexual function is still controversial in patients with benign prostate enlargement. This study aimed at comparing sexual function in patients with open prostatectomy and TURP before and after surgery. Materials and methods: This cross-sectional study was performed in 100 patients with benign prostatic hyperplasia aged 50-75 years who underwent surgery in 2019 in hospitals affiliated with Babol University of Medical Sciences based on prostate size in two groups of 50 TURP (n=50) and open prostatectomy (n=50). Patients' sexual function was evaluated and compared between the two groups using the International Index of Erectile Function (IIEF-15), before and three and six months after the surgery. Data analysis was done applying Chi-square, Fisher's exact test, t-test, and analysis of variance. Results: The mean age in TURP group was 71. 42 ±,6. 27 and in open prostatectomy group was 73. 40±, 5. 91 years. The total scores for the IIEF-15 before, three, and six months after the open prostatectomy group were 37. 40 ±, 10. 82, 37. 74 ±, 9. 21, and 38. 22 ±,9. 31, respectively, and in TURP group were 23. 40±, 7. 62, 37. 34±, 7. 38, and 37. 29±, 7. 11, respectively. The scores showed no significant differences in sexual function between the two procedures (P>0. 05). Intense sexual dysfunction was seen in five (10%) patients and eight (16%) patients, six months after TURP and open prostatectomy, respectively. Mild dysfunction was not observed after TURP, but it was seen in two (4%) patients after open prostatectomy. Conclusion: In current study, open prostatectomy and TURP did not affect sexual function.

Bladder leiomyoma constitutes less than 0. 5% of all bladder tumors. Until now, there have been about 250 case reports of bladder leiomyoma. We present a case of large bladder leiomyoma, that was treated successfully with Transurethral resection. The patient presented to our clinic with both obstructive and irritative urinary complaints. Cystoscopy showed a mass lesion completely obstructing the bladder neck at the junction of right lateral wall and floor, which did not extend to ureteral orifices. A Transurethral resection was performed at the same session of cystoscopy. At the postoperative 3rd month control visit, the patient's obstructive symptoms were completely healed but her irritative symptoms continued. A repeat cystoscopy revealed residual tumoral tissue remaining at the floor of the previous surgical area. Transurethral resection was performed, and these tissues were completely resected. At the control visit that was 3 months after the second Transurethral resection procedure, the patient was free from any urinary complaints. In conclusion, large bladder leiomyomas can be treated successfully with endoscopic approaches.

Background & Objectives: Benign prostatic hyperplasia is one of the most common diseases in males and Transurethral resection of Prostate (TUR-P) is a standard method for its surgery. Distilled water is used to clean the field of operation from blood and debris. The over absorption of this washing fluid can lead to hemodynamic disorders and neurological complications called TUR-P syndrome. Because of hemolysis and ATN, most of the urologists, nowadays, prefer to use non-hemolytic solutions such as cytol and glycine 1.5%. Distilled water is widely used in Iran. Replacing this water with a nonhemolytic and hypoosmolar solution with reasonable price such as manitol 3% seems reasonable. This study was carried out to campare manitol 3% with distilled water during TUR-P. Methods: In a double-blind randomized clinical trial, we studied 78 patients with BPH who were admitted to Shahid Moddares hospital in Tehran for TUR-P. These patients were allocated to disstiled water group and manito13% group. Na, K, Cr, BUN, CBC, U/A, U/C, 24 hr urine volume and creatinine were checked preoperatively to determine GFR, Na, K, BUN and CBC were checked right after, 4 hours after and on the morning after the operation. Clinical signs of TUR-P syndrome were recorded in the patients as bradycardia, hypertension and neurologic sign.Results: Mean age was 68.6 in distilled water group and 66.4 in the manitol group. Mean weight of resected tissues, mean volume of the solution used and mean resection time were 19.8 gr, 19 litre, 50.8 minutes respectively in distilled water group and 20.2 gr, 20.3 litre and 51 minutes in the manitol 3% group. These differences were not statistically significant. The difference between decrease in serum Na and serum osmolality was not significant in two groups, however, hemolysis rate in two groups was statistically significant (p<0.01). The incidence rate of TUR-P syndrome was 34% in the distilled water group and 18% in manitol group. This difference was not statistically significant. Postoperative creatinine increase was 0.625 mg/dl in distilled water group and 0.04 mg/dl in manitol group. This was not statistically significant.Conclusion: Regarding the role of distilled water in hemolysis and ATN and due to the unavailability of non - hemolytic solutions such as glycine and cytol in Iran, the use of manitol 3% soluion which is a cost-effective, non hemolytic and hypoosmolar solution is recommended.