Objective: To explore the safety of the concurrent transurethral
resection of the prostate (TURP) and transurethral resection of
bladder tumor (TURBT).
Methods: A total of 16 patients age 52-80 years (mean: 62 years)
with benign prostatic hyperplasia (BPH) and prostate cancer were
treated in our hospital from January 2001 to January 2011. All
these 16 patients had hematuria, accompanied with various lower
urinary tract symptoms (LUTS). Four patients had acute urinary
retention and 11 experienced dysuria. All patients underwent
ultrasound, cystoscopy, and CT. These tumors were solitary in 12
patients and multiple in 4 patients. The prostate showed moderate
hyperplasia in 11 patients and severe hyperplasia in 5 patients.
TURP and TURBT were performed in 12 cases, and concurrent
TURP and TURBT was performed in 4 cases.
Results: All these 16 patients were followed up. The follow-up
ranged 6 months (n=1), 12 months (n=3), 24 months (n=10),
and 30-60 months (n=2). Three patients experienced recurrence
6 months, 28 months, and 36 months after surgery, respectively.
The sites of recurrence were not in situ or prostate fossa. LUTS
and dysuria were cured or improved after surgery.
Discussion: Clinically, BPH combined with prostate cancer is
not a rare condition due to their same ages of high prevalence.
Furthermore, some reports have indicated that BPH may trigger
the development of prostate cancer. Diagnosis of BPH should
also pay attention to the potential existence of prostate cancer.
Whether the concurrent surgeries for both BPH and prostate
cancer may cause neoplasm seeding and thus increase the
risk of tumor relapse is still controversial. For elderly patients
with mild BPH, treatment may be focused on prostate cancer
only. For moderate and severe BPH, concurrent surgeries
may be beneficial and appropriate. When the surgeries were
performed concurrently, the prostate cancer is resected firstly.
When TURBT is performed, the tumors are washed out using
Ellic flusher and then TURP is performed, so as to ensure the
procedures are performed under a "tumor-free" environment.
Meanwhile, the clear operational field is also helpful to remove
the tumors. However, since the concurrent surgeries require
continuous prostate brushing, and therefore chemotherapy
drugs can not be administered in the urinary bladder early. In
fact, after the brushing stops, chemotherapy drugs should be administered early to prevent neoplasm seeding.