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Category: Volume 05 Issue 10 October 2017
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Title: Study of Outcome, Morbidity and Mortality of Transurethral Resection of Prostate in Patients with Renal Insufficiency Not Requiring Dialysis

Authors: Selvakumar Soman, Kannan Subramanian Ramasamy

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i10.171

Abstract

Introduction: Benign Prostate Hyperplasia (BPH) is a common disease in adult men and its incidence is age related. Attending to high prevalence of BPH in older men with renal insufficiency it is invaluable to take into consideration the relationship between these two clinical entities. The purpose of this study was to determine the incidence of renal failure associated with BPH, effect of TURP in the morbidity and mortality of patients with renal failure. The aims of this study are to study the prevalence of co-morbid factors in patients with Benign prostatic hyperplasia and non dialysis requiring renal insufficiency, Study of treatment outcome following  transurethral resection of prostate (TURP) with non dialysis requiring renal failure and to study of complications associated with TURP  in these patients.

Materials and Methods: This is a Prospective study conducted between JAN 2015 to AUG 2017 in Department of Urology, Government Kanyakumari Medical College, Nagercoil, Tamilnadu, India. This is a study of 40 cases of Benign prostatic hyperplasia in normal and in patients with non dialysis requiring renal failure who underwent TURP. The inclusion criteria being all patients with Non dialysis requiring Renal Dysfunction associated with BPH. The exclusion criteria being histologically proven malignant prostatomegaly and patients with end stage renal disease requiring hemodialysis.

Results and Conclusion: The incidence of renal failure associated with BPH in our study was about 12.5%. After excluding patients with prostatic malignancy, patients needing dialysis, the study group constituted 5%. There was no significant variation in preoperative and postoperative levels of serum sodium, potassium levels in patients with nondialysis requiring renal failure (S.creatinine less than 3), when compared to normal patients. Complications of TURP in patients who had nondialysis requiring renal failure, was on the higher side. Bleeding as a complication requiring blood transfusion was noted in 20% of patients compared to normal patients. But overall complication rate was not statistically significant. This can be attributed to either small sample size, improvement in instruments like continuous flow resectoscope, use of non hemolytic irrigation solutions can be a factor. The outcome following TURP was successful with restoration in normal renal function and normal voiding pattern in majority of patients and it was further noted that the successful outcome of TURP in these patients were influenced by various factors such as age, duration of symptoms, severity of lower urinary tract symptoms, severity of renal failure at the time of presentation. The size of Prostate gland had no correlation with the final outcome.

Keywords: Benign prostatic hyperplasia, Renal failure, Chronic kidney disease, Transurethral resection of prostate.

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Corresponding Author

Selvakumar Soman

Department of Urology, Government Kanyakumari Medical College,

Nagercoil, Tamilnadu, India