Elsevier

Urology

Volume 81, Issue 6, June 2013, Pages 1315-1319
Urology

Prostatic Diseases and Male Voiding Dysfunction
Laser-assisted Bipolar Transurethral Resection of the Prostate With the Oyster Procedure for Patients With Prostate Glands Larger Than 80 mL

https://doi.org/10.1016/j.urology.2013.01.037Get rights and content

Objective

To evaluate the safety and efficacy of diode laser-assisted bipolar transurethral resection of the prostate (TURP) with an oyster procedure for large prostate glands (>80 mL).

Methods

A total of 43 men who presented with lower urinary tract symptoms because of large prostate (>80 mL) obstruction were enrolled in our study. All of these patients underwent the oyster procedure. Measurements included the urinary flow rate, symptom score, duration of catheterization, length of hospital stay, and urinary flow rate. All patients were re-examined 3, 6, and 12 months after surgery.

Results

The patients who underwent oyster procedures experienced good and durable subjective and functional outcomes for 1 year. Small changes in hemoglobin were noted, and no patients needed blood transfusions. No cases of TURP syndrome were noted. Bladder neck contracture was noted in 2 patients (Clavien-Dindo grade III) because of subtrigonal injury during prostate enucleation, and the other complications were minor (Clavien-Dindo grade I to II).

Conclusion

The oyster procedure is a safe and effective procedure for large prostates (>80 mL).

Section snippets

Patients

We retrospectively reviewed the data on men who were diagnosed between April 2008 and April 2011 with bladder outlet obstruction secondary to BPH greater than 80 mL. Detailed medical histories were collected, physical examinations were performed, and urinalyses were undertaken in all patients. Prostatic transrectal ultrasonography-calculated prostate volume, peak urinary flow rate (Qmax), and postvoid residual urine volume were recorded. A digital rectal examination was performed, and

Patient Characteristics

A total of 43 men were enrolled; their baseline data are shown in Table 1. The median prostate volume was 98.9 mL. Fifteen patients received surgery because of acute urine retention. The other patients received TURP because of failed medical therapies. No prostate adenocarcinoma was detected by pathological examination in the resected tissue. All patients were followed for at least 12 months.

Peri-operative Data

The median resected weight was 71 g. The median operative time was 117 minutes. The enucleation time,

Comment

Our study demonstrated that the oyster procedure is a safe and effective treatment for large prostatic adenomas. The oyster procedure provides an easy-to-learn technique for urologists to perform prostatic enucleation with minimally invasive treatment. In general, this procedure provides good subjective and functional outcomes with low surgical morbidity.

Monopolar TURP is still the standard treatment for patients with lower urinary tract symptoms because of BPH. Although the mortality rate has

Conclusions

The oyster procedure appears to be an effective and safe procedure for large prostates (>80 mL) at 1-year follow-up. It has the potential to become an attractive alternative procedure to open prostatectomy for patients with large prostates.

Cited by (9)

  • Management of prostate enlargement with acute urinary retention: Diode laser vaporization in combination with bipolar transurethral resection of the prostate

    2016, Urological Science
    Citation Excerpt :

    In addition, compared with the results of the oyster technique reported in the study of Shih et al,12 a slightly steeper hemoglobin drop (0.8 g/dL vs. 0.6 g/dL) but reduced operation time (96 min vs. 117 min) were observed in our combination group. However, no subtrigonal injury occurred in our study, whereas it had occurred in two of the first five patients in the study of Shih et al.12 This is because we removed tissue by bipolar TURP, which is a more formal resection technique and easy to learn. In our hospital, all patients underwent a preoperative urinalysis study and received empiric antibiotic treatment if UTI was diagnosed.

View all citing articles on Scopus

Hung-Jen Shih and Jian-Ting Chen contributed equally to this work.

Financial Disclosure: The authors declare that they have no relevant financial interests.

View full text