Transurethral resection of the prostate across continents: a meta-analysis evaluating quality of gold standard in the twenty-first century

Category	Detail
Condition	Benign prostatic hyperplasia (BPH) causing urinary obstruction in males
Key Mechanisms	Transurethral resection of the prostate (TURP) surgically removes prostatic tissue to relieve obstruction
Target Population	Male patients with enlarged prostates due to BPH
Care Setting	Surgical urology settings worldwide, including Europe, Asia, Africa, North and South America, and Australia

TURP remains the gold standard surgical treatment for BPH since 1926 with enduring global predominance.
Surgeon expertise and procedure volume significantly influence TURP effectiveness and complication rates.
Technical advancements in endoscopic tools have variably impacted TURP-associated complications.

Use International Prostate Symptom Score (IPSS), maximum urine flow rate (Qmax), postvoid residual volume (PVR), prostate-specific antigen (PSA), and prostate volume assessments to evaluate BPH severity.

Consider TURP as the benchmark surgical treatment for BPH when minimally invasive options are indicated.
Ensure procedures are performed by experienced urologists to optimize tissue resection and outcomes.

Monitor perioperative and postoperative parameters including IPSS, Qmax, PVR, PSA, Sexual Health Inventory For Men (SHIM), and complications at baseline, 3 months, 12 months, and ≥36 months post-TURP.

Be vigilant for complications such as transurethral resection syndrome, bleeding, blood transfusion, clot evacuation, urinary retention, urinary tract infection, irritative symptoms, urinary incontinence, erectile dysfunction, retrograde ejaculation, urethral stricture, bladder neck stenosis, incidental prostate cancer, and need for retreatment.

Patients with BPH undergoing surgical treatment via TURP across multiple continents including Europe, Asia, Africa, and others.

Higher surgeon volume correlates with improved outcomes; technical improvements may reduce complications but results vary by region and expertise.

Prioritize TURP as the reference surgical approach for BPH treatment in clinical decision-making.
Select experienced urologists for TURP to maximize tissue resection efficiency and minimize complications.
Incorporate standardized symptom and functional scoring systems pre- and post-operatively to monitor treatment efficacy.
Consider regional variations in outcomes and complication rates when evaluating TURP quality and adopting new surgical techniques.
Maintain rigorous perioperative monitoring to promptly identify and manage complications.

Clinical Scorecard: Global Perspectives on Transurethral Resection of the Prostate: A Meta-Analysis Assessing the Current Quality of the Gold Standard Surgical Approach