A retrospective study shows that a new surgical transurethral split of the prostate (TUSP) approach delivered promising long-term benefits for patients with benign prostatic hyperplasia-induced lower urinary tract obstructions.

Benign prostatic hyperplasia (BPH) is a common condition marked by an enlarged prostate. It can lead to urinary tract obstruction and reduce patient quality of life.

For decades, the invasive transurethral resection of the prostate (TURP) has been used as a standard procedure to treat BPH, though TURP is associated with relatively high and frequent postoperative complications.

Many efforts have been made to improve therapeutic possibilities for BPH patients.

In 2015, a new surgical approach based on the TUSP procedure showed good therapeutic results with few complications in 113 BPH patients. TUSP requires the insertion of a catheter that upon inflation pushes excess tissue away from the urethra and improves urine flow.

In the study review, “Effect of transurethral split of the prostate using a double-columnar balloon catheter for benign prostatic hyperplasia: A single-center experience of 565 consecutive patients,” published in Medicine, researchers sought to determine the long-term therapeutic effect of the new TUSP protocol. The technique uses an improved double-columnar balloon catheter in patients with BPH-induced lower urinary tract obstructions.

The catheter can expand the neck area of the urinary bladder and the prostatic urethra portion of the urethra close to the prostate gland with a proximal balloon. It also can also expand the membranous urethra, also close to the prostate, with a distal balloon.

The report included 565 patients who underwent TUSP surgery. The patients had histories of BPH-induced lower urinary tract obstructions and alterations in urinary flow or urinary retention.

The authors showed that the patients had improved urinary flow rates and reductions in the amount of urine retained in the bladder after surgery. The patients also presented improvement in the International Prostate Symptoms Score (IPSS) – a measure of BHP disease progression. Overall quality of life improvements were also reported.

During follow-up, ranging from 38 to 99 months, only two patients reported painful or difficult urination situations. No defects or other complications were detected after TUSP.

“The TUSP with a double-columnar balloons [proximal and distal] catheter was a safe and long-term efficient treatment for BPH, with minimal invasion, short operative time, few post-operative complications, and low recurrence rate,” the authors wrote.