Clinical Application Effect of Postoperative Nursing Intervention on Patients Undergoing Transurethral Prostatectomy: A Systematic Review and Meta-Analysis
Abstract
Background: To study the clinical effect of postoperative nursing on patients undergoing transurethral resection of the prostate (TURP).
Methods: The relevant researches about nursing intervention effect evaluation after TURP during January 2000 to May 2024 were selected from databases. These were sorted into an intervention group (Int group) and a control group (Ctrl group) with different nursing methods. Theemotional status, length of hospital stays (LOHS), nursing satisfaction, the incidence, volume, and frequency of urinary incontinence (UI), and the incidences of urinary hemorrhage (UH), bladder spasm (BS), and catheter occlusion (CO) were compared after intervention.
Results: Eleven articles and 1,020 cases were included. The LOHS in the Int group was much shorter (mean difference (MD)=-2.91, 95% confidence interval (CI): -4.47~-1.35, Z=3.66, P=0.0002). The nursing satisfaction was significantly improved (odds ratio (OR)=5.70, 95% CI: 3.65-8.90, Z=7.64, P<0.00001). For complications, incidence of UI (OR=0.41, 95% CI: 0.26-0.66, Z=3.72, P=0.0002), the volume of UI (MD=-66.17, 95% CI: -124.74~-11.60, Z=2.36, P=0.02), and the frequency of UI (MD=-1.18, 95% CI: -1.69~-0.67, Z=4.55, P<0.00001) greatly reduced. The incidences of UH (OR=0.43, 95% CI: 0.21-0.87, Z=2.35, P=0.02), BS (OR=0.24, 95% CI: 0.14-0.42, Z=4.97, P<0.00001), and CO (OR=0.20, 95% CI: 0.11-0.36, Z=5.21, P<0.00001) were also highly reduced.
Conclusion: Postoperative nursing intervention could effectively shorten LOHS after TURP in patients with benign prostatic hyperplasia (BPH), improving the nursing satisfaction and reducing the incidence of postoperative complications.
1. Plochocki A, King B (2022). Medical Treatment of Benign Prostatic Hyper-plasia. Urol Clin North Am, 49(2):231–238.
2. Infante Hernández S, Gómez Rivas J, Moreno Sierra J(2024). Benign prostatic hyperplasia. Hiperplasia benigna de próstata. Med Clin (Barc), 163(8):407–414.
3. Miernik A, Gratzke C (2020). Current Treatment for Benign Prostatic Hyper-plasia. Dtsch Arztebl Int, 117(49):843-854.
4. Foo KT (2019). What is a disease? What is the disease clinical benign prostatic hy-perplasia (BPH). World J Urol, 37(7):1293-1296.
5. Cicero AFG, Allkanjari O, Busetto GM, et al (2019). Nutraceutical treatment and prevention of benign prostatic hyper-plasia and prostate cancer. Arch Ital Urol Androl, 91(3): 10.4081/aiua.2019.3.139.
6. Rastrelli G, Vignozzi L, Corona G, et al (2019). Testosterone and Benign Prostat-ic Hyperplasia. Sex Med Rev, 7(2):259-271.
7. Te AE (2019). Recent advances in prosta-tectomy for benign prostatic hyperplas-ia. F1000Res, 8:F1000 Faculty Rev-1528.
8. Abt D, Müllhaupt G, Hechelhammer L, et al (2021). Prostatic Artery Embolisation Versus Transurethral Resection of the Prostate for Benign Prostatic Hyperplas-ia: 2-yr Outcomes of a Randomised, Open-label, Single-centre Trial. Eur Urol, 80(1):34-42.
9. Abdelhakim MA, RammahA, Abozamel AH, et al (2021). Does detrusor underac-tivity affect the results of transurethral resection of prostate? Int Urol Nephrol, 53(2):199-204.
10. Al-Radhi MA, Lun LK, Safi M, et al (2021). Can bipolar transurethral enucleation of the prostate be a better alternative to the bipolar transurethral resection of the prostate?: A prospective comparative study. Medicine (Baltimore), 100(20):e25745.
11. Bayat R, Shahsavari H, Faghihzadeh S, et al (2020). Effect of the Nurse-Led Sexual Health Discharge Program on the Sexu-al Function of Older Patients Undergo-ing Transurethral Resection of Prostate: A Randomized Controlled Trial. Geriat-rics (Basel), 5(1):13.
12. Adhikari B, Shrestha A, Basnet RB, et al (2021). Monopolar Transurethral Resec-tion of Prostate for Benign Prostatic Hyperplasia in Patients with and With-out Preoperative Urinary Catheteriza-tion: A Prospective Comparative Study. Cureus, 13(7):e16705.
13. Afandiyev F, Ugurlu O (2022). Factors pre-dicting the development of urethral stricture after bipolar transurethral re-section of the prostate. Rev Assoc Med Bras (1992), 68(1):50-55.
14. Robinson C, Hepburn A, Turner RM, et al (2022). The role of intra-operative void score during transurethral resection of prostate as a marker of efficacy: a feasi-bility study. ANZ J Surg, 92(6):1492-1497.
15. Vigneswaran G, Maclean D, Hadi M, et al (2021). Prostatic Artery Embolization (PAE) and Transurethral Resection of the Prostate (TURP) have a Differential Impact on Lower Urinary Tract Symp-toms (LUTS): Retrospective Analysis of the Multicentre UK-ROPE (UK Register of Prostate Embolization) Study. Cardio-vasc Intervent Radiol, 44(7):1095-1102.
16. Büyükyilmaz F, Culha Y, Zümreler H, et al (2020). The effects of bladder training on bladder functions after transurethral resection of prostate. J Clin Nurs, 29(11-12): 1913-1919.
17. Ding A, Cao HL, Wang LH, et al (2016). A novel automatic regulatory device for continuous bladder irrigation based on wireless sensor in patients after tran-surethral resection of the prostate: A prospective investigation. Medicine (Balti-more), 95(52):e5721.
18. Jiang JL, Du LT, Wang XH, et al (2022). Specific nursing improves postoperative urine control function and the self-efficacy of patients undergoing radical prostatectomies. Am J Transl Res, 14(3):1695-1704.
19. Liu YL, Li MT, Li RY, et al (2020). Influence of seamless nursing on the stress state of patients undergoing transurethral pros-tate resection. Int J Clin Exp Med, 13 (11): 8790-8797.
20. Lu CH, Wang HX (2018). Effects of pain-free nursing care plus mind mapping on postoperative pain and urinary inconti-nence in patients after transurethral prostate resection. Int J Clin Exp Med, 11(5): 5383-5389.
21. Lu PT, Wu CY (2022). Continuous Psycho-logical Nursing Based on Grey Cluster-ing Algorithm in Patients after Tran-surethral Resection of Prostate. Comput Math Methods Med, 2022: 5400479.
22. Ma ZZ, Han YX, Wang WZ, et al (2020). The use of a homemade rate adjustment card in patients with continuous bladder irrigation after transurethral resection of the prostate. Transl Androl Urol, 9(5): 2227-2234.
23. Sayed KA, Sayed SY, Ahmed W, et al (2021). Effect of Nursing Instructions on pa-tient’s knowledge and Potential Postop-erative Complications after Tran-surethral Resection of the Prostate. As-siut Sci Nurs J, 9(25): 136-145.
24. Talreja V, Ali A, Saeed S, et al (2016). Trail without Catheter after Transurethral Re-section of Prostate: Clamp It or Not? Scientifica (Cairo), 2016: 1562153.
25. Yung PMB, Kam SC, French P, et al (2002). A controlled trial of music and pre‐operative anxiety in Chinese men un-dergoing transurethral resection of the prostate. J Adv Nurs, 39(4): 352-359.
26. Zhang XY, Bo MY, Zeng R, et al (2022). Analgesic Effects of Dexmedetomidine Combined with Spinal and Epidural Anesthesia Nursing on Prostate Hyper-plasia Patients after Transurethral Re-section of Prostate by Intelligent Algo-rithm-Based Magnetic Resonance Imag-ing. Comput Math Methods Med, 2022: 4243244.
27. Herden J, Ebert T, Schlager D, et al (2021). Perioperative Outcomes of Tran-surethral Resection, Open Prostatecto-my, and Laser Therapy in the Surgical Treatment of Benign Prostatic Obstruc-tion: A “Real-World” Data Analysis from the URO-Cert Prostate Centers. Urol Int, 105(9-10): 869-874.
28. Hussain M, Khalique A, Maheshwari PK, et al (2021). Outcomes of Transurethral Resection of Prostate in Patients with and without Renal Failure Secondary to an Enlarged Prostate. J Coll Physicians Surg Pak, 31(10): 1247-1249.
29. Janjua TK, Yousuf MA, Iqbal MT, et al (2021). Incidental finding of prostate cancer in Transurethral Resection of Prostate (TURP) specimens: a retrospec-tive analysis from a Tertiary Care Hos-pital in Pakistan. Pan Afr Med J, 39: 20.
30. Khawcharoenporn T, Kanoktipakorn P (2022). Effectiveness of appropriate an-tibiotic prophylaxis for transurethral re-section of the prostate in the era of an-tibiotic resistance. Infect Control Hosp Epi-demiol, 43(11):1693-1697.
31. Knight GM, Talwar A, Salem R, et al (2021). Systematic Review and Meta-analysis Comparing Prostatic Artery Emboliza-tion to Gold-Standard Transurethral Re-section of the Prostate for Benign Pros-tatic Hyperplasia. Cardiovasc Intervent Ra-diol, 44(2): 183-193.
32. Leitner L, Ujmajuridze A, Chanishvili N, et al (2021). Intravesical bacteriophages for treating urinary tract infections in pa-tients undergoing transurethral resection of the prostate: a randomised, placebo-controlled, double-blind clinical trial. Lancet Infect Dis, 21(3): 427-436.
33. Liu HM, Tian Y, Luo GH, et al (2021). Mod-ified bladder outlet obstruction index for powerful efficacy prediction of transurethral resection of prostate with benign prostatic hyperplasia. BMC Urol, 21(1): 170.
34. Liu HM, Tian Y, Su ZY, et al (2021). Effect of total prostate volume and transitional zone volume on the curative effect of transurethral resection of prostate in benign prostatic hyperplasia. Zhonghua Yi Xue Za Zhi, 101(2):137-141.
35. Patel N, Yung N, Vigneswaran G, et al (2021). 1-year cost-utility analysis of prostate artery embolization (PAE) ver-sus transurethral resection of the pros-tate (TURP) in benign prostatic hyper-plasia (BPH). BMJ Surg Interv Health Tech-nol, 3(1): e000071.
36. Porcaro AB, Siracusano S, Amigoni N, et al (2021). The Influence of Endogenous Testosterone on Incidental Prostate Cancer after Transurethral Prostate Re-section. Urol Int, 105(9-10): 826-834.
37. Sahu S, Parmar K, Kumar S, et al (2021). Ef-fect of Transurethral Resection of the Prostate on Urodynamic Parameters in Patients with Benign Prostatic Enlarge-ment with Upper Urinary Tract Dilata-tion. Urol Int, 105(9-10): 846-851.
38. Selvaraj N, Jain G, Tripathy DK, et al (2021). Accuracy of non-invasive hae-moglobin measurements in patients un-dergoing transurethral resection of pros-tate surgery. Indian J Anaesth, 65(Suppl 2): S62-S68.
39. Taha DE (2021). Prostatic resection cavity large stone post transurethral resection of the prostate (TURP). A rare case sce-nario. Int J Surg Case Rep, 81: 105726.
40. Westhofen T, Schott M, Keller P, et al (2021). Superiority of Holmium Laser Enucleation of the Prostate over Tran-surethral Resection of the Prostate in a Matched-Pair Analysis of Bleeding Complications Under Various An-tithrombotic Regimens. J Endourol, 35(3): 328-334.
41. Xu ZN, Zhou ZB, Mu YM, et al (2021). An Updated Meta-Analysis of the Efficacy and Safety of Prostatic Artery Emboliza-tion vs. Transurethral Resection of the Prostate in the Treatment of Benign Prostatic Hyperplasia. Front Surg, 8:779571.
42. You AH, Lee JY, Choi JH, et al (2021). Hy-perchloremic metabolic acidosis during bipolar transurethral resection of the prostate: a report of two cases. J Int Med Res, 49(6):3000605211024480.
2. Infante Hernández S, Gómez Rivas J, Moreno Sierra J(2024). Benign prostatic hyperplasia. Hiperplasia benigna de próstata. Med Clin (Barc), 163(8):407–414.
3. Miernik A, Gratzke C (2020). Current Treatment for Benign Prostatic Hyper-plasia. Dtsch Arztebl Int, 117(49):843-854.
4. Foo KT (2019). What is a disease? What is the disease clinical benign prostatic hy-perplasia (BPH). World J Urol, 37(7):1293-1296.
5. Cicero AFG, Allkanjari O, Busetto GM, et al (2019). Nutraceutical treatment and prevention of benign prostatic hyper-plasia and prostate cancer. Arch Ital Urol Androl, 91(3): 10.4081/aiua.2019.3.139.
6. Rastrelli G, Vignozzi L, Corona G, et al (2019). Testosterone and Benign Prostat-ic Hyperplasia. Sex Med Rev, 7(2):259-271.
7. Te AE (2019). Recent advances in prosta-tectomy for benign prostatic hyperplas-ia. F1000Res, 8:F1000 Faculty Rev-1528.
8. Abt D, Müllhaupt G, Hechelhammer L, et al (2021). Prostatic Artery Embolisation Versus Transurethral Resection of the Prostate for Benign Prostatic Hyperplas-ia: 2-yr Outcomes of a Randomised, Open-label, Single-centre Trial. Eur Urol, 80(1):34-42.
9. Abdelhakim MA, RammahA, Abozamel AH, et al (2021). Does detrusor underac-tivity affect the results of transurethral resection of prostate? Int Urol Nephrol, 53(2):199-204.
10. Al-Radhi MA, Lun LK, Safi M, et al (2021). Can bipolar transurethral enucleation of the prostate be a better alternative to the bipolar transurethral resection of the prostate?: A prospective comparative study. Medicine (Baltimore), 100(20):e25745.
11. Bayat R, Shahsavari H, Faghihzadeh S, et al (2020). Effect of the Nurse-Led Sexual Health Discharge Program on the Sexu-al Function of Older Patients Undergo-ing Transurethral Resection of Prostate: A Randomized Controlled Trial. Geriat-rics (Basel), 5(1):13.
12. Adhikari B, Shrestha A, Basnet RB, et al (2021). Monopolar Transurethral Resec-tion of Prostate for Benign Prostatic Hyperplasia in Patients with and With-out Preoperative Urinary Catheteriza-tion: A Prospective Comparative Study. Cureus, 13(7):e16705.
13. Afandiyev F, Ugurlu O (2022). Factors pre-dicting the development of urethral stricture after bipolar transurethral re-section of the prostate. Rev Assoc Med Bras (1992), 68(1):50-55.
14. Robinson C, Hepburn A, Turner RM, et al (2022). The role of intra-operative void score during transurethral resection of prostate as a marker of efficacy: a feasi-bility study. ANZ J Surg, 92(6):1492-1497.
15. Vigneswaran G, Maclean D, Hadi M, et al (2021). Prostatic Artery Embolization (PAE) and Transurethral Resection of the Prostate (TURP) have a Differential Impact on Lower Urinary Tract Symp-toms (LUTS): Retrospective Analysis of the Multicentre UK-ROPE (UK Register of Prostate Embolization) Study. Cardio-vasc Intervent Radiol, 44(7):1095-1102.
16. Büyükyilmaz F, Culha Y, Zümreler H, et al (2020). The effects of bladder training on bladder functions after transurethral resection of prostate. J Clin Nurs, 29(11-12): 1913-1919.
17. Ding A, Cao HL, Wang LH, et al (2016). A novel automatic regulatory device for continuous bladder irrigation based on wireless sensor in patients after tran-surethral resection of the prostate: A prospective investigation. Medicine (Balti-more), 95(52):e5721.
18. Jiang JL, Du LT, Wang XH, et al (2022). Specific nursing improves postoperative urine control function and the self-efficacy of patients undergoing radical prostatectomies. Am J Transl Res, 14(3):1695-1704.
19. Liu YL, Li MT, Li RY, et al (2020). Influence of seamless nursing on the stress state of patients undergoing transurethral pros-tate resection. Int J Clin Exp Med, 13 (11): 8790-8797.
20. Lu CH, Wang HX (2018). Effects of pain-free nursing care plus mind mapping on postoperative pain and urinary inconti-nence in patients after transurethral prostate resection. Int J Clin Exp Med, 11(5): 5383-5389.
21. Lu PT, Wu CY (2022). Continuous Psycho-logical Nursing Based on Grey Cluster-ing Algorithm in Patients after Tran-surethral Resection of Prostate. Comput Math Methods Med, 2022: 5400479.
22. Ma ZZ, Han YX, Wang WZ, et al (2020). The use of a homemade rate adjustment card in patients with continuous bladder irrigation after transurethral resection of the prostate. Transl Androl Urol, 9(5): 2227-2234.
23. Sayed KA, Sayed SY, Ahmed W, et al (2021). Effect of Nursing Instructions on pa-tient’s knowledge and Potential Postop-erative Complications after Tran-surethral Resection of the Prostate. As-siut Sci Nurs J, 9(25): 136-145.
24. Talreja V, Ali A, Saeed S, et al (2016). Trail without Catheter after Transurethral Re-section of Prostate: Clamp It or Not? Scientifica (Cairo), 2016: 1562153.
25. Yung PMB, Kam SC, French P, et al (2002). A controlled trial of music and pre‐operative anxiety in Chinese men un-dergoing transurethral resection of the prostate. J Adv Nurs, 39(4): 352-359.
26. Zhang XY, Bo MY, Zeng R, et al (2022). Analgesic Effects of Dexmedetomidine Combined with Spinal and Epidural Anesthesia Nursing on Prostate Hyper-plasia Patients after Transurethral Re-section of Prostate by Intelligent Algo-rithm-Based Magnetic Resonance Imag-ing. Comput Math Methods Med, 2022: 4243244.
27. Herden J, Ebert T, Schlager D, et al (2021). Perioperative Outcomes of Tran-surethral Resection, Open Prostatecto-my, and Laser Therapy in the Surgical Treatment of Benign Prostatic Obstruc-tion: A “Real-World” Data Analysis from the URO-Cert Prostate Centers. Urol Int, 105(9-10): 869-874.
28. Hussain M, Khalique A, Maheshwari PK, et al (2021). Outcomes of Transurethral Resection of Prostate in Patients with and without Renal Failure Secondary to an Enlarged Prostate. J Coll Physicians Surg Pak, 31(10): 1247-1249.
29. Janjua TK, Yousuf MA, Iqbal MT, et al (2021). Incidental finding of prostate cancer in Transurethral Resection of Prostate (TURP) specimens: a retrospec-tive analysis from a Tertiary Care Hos-pital in Pakistan. Pan Afr Med J, 39: 20.
30. Khawcharoenporn T, Kanoktipakorn P (2022). Effectiveness of appropriate an-tibiotic prophylaxis for transurethral re-section of the prostate in the era of an-tibiotic resistance. Infect Control Hosp Epi-demiol, 43(11):1693-1697.
31. Knight GM, Talwar A, Salem R, et al (2021). Systematic Review and Meta-analysis Comparing Prostatic Artery Emboliza-tion to Gold-Standard Transurethral Re-section of the Prostate for Benign Pros-tatic Hyperplasia. Cardiovasc Intervent Ra-diol, 44(2): 183-193.
32. Leitner L, Ujmajuridze A, Chanishvili N, et al (2021). Intravesical bacteriophages for treating urinary tract infections in pa-tients undergoing transurethral resection of the prostate: a randomised, placebo-controlled, double-blind clinical trial. Lancet Infect Dis, 21(3): 427-436.
33. Liu HM, Tian Y, Luo GH, et al (2021). Mod-ified bladder outlet obstruction index for powerful efficacy prediction of transurethral resection of prostate with benign prostatic hyperplasia. BMC Urol, 21(1): 170.
34. Liu HM, Tian Y, Su ZY, et al (2021). Effect of total prostate volume and transitional zone volume on the curative effect of transurethral resection of prostate in benign prostatic hyperplasia. Zhonghua Yi Xue Za Zhi, 101(2):137-141.
35. Patel N, Yung N, Vigneswaran G, et al (2021). 1-year cost-utility analysis of prostate artery embolization (PAE) ver-sus transurethral resection of the pros-tate (TURP) in benign prostatic hyper-plasia (BPH). BMJ Surg Interv Health Tech-nol, 3(1): e000071.
36. Porcaro AB, Siracusano S, Amigoni N, et al (2021). The Influence of Endogenous Testosterone on Incidental Prostate Cancer after Transurethral Prostate Re-section. Urol Int, 105(9-10): 826-834.
37. Sahu S, Parmar K, Kumar S, et al (2021). Ef-fect of Transurethral Resection of the Prostate on Urodynamic Parameters in Patients with Benign Prostatic Enlarge-ment with Upper Urinary Tract Dilata-tion. Urol Int, 105(9-10): 846-851.
38. Selvaraj N, Jain G, Tripathy DK, et al (2021). Accuracy of non-invasive hae-moglobin measurements in patients un-dergoing transurethral resection of pros-tate surgery. Indian J Anaesth, 65(Suppl 2): S62-S68.
39. Taha DE (2021). Prostatic resection cavity large stone post transurethral resection of the prostate (TURP). A rare case sce-nario. Int J Surg Case Rep, 81: 105726.
40. Westhofen T, Schott M, Keller P, et al (2021). Superiority of Holmium Laser Enucleation of the Prostate over Tran-surethral Resection of the Prostate in a Matched-Pair Analysis of Bleeding Complications Under Various An-tithrombotic Regimens. J Endourol, 35(3): 328-334.
41. Xu ZN, Zhou ZB, Mu YM, et al (2021). An Updated Meta-Analysis of the Efficacy and Safety of Prostatic Artery Emboliza-tion vs. Transurethral Resection of the Prostate in the Treatment of Benign Prostatic Hyperplasia. Front Surg, 8:779571.
42. You AH, Lee JY, Choi JH, et al (2021). Hy-perchloremic metabolic acidosis during bipolar transurethral resection of the prostate: a report of two cases. J Int Med Res, 49(6):3000605211024480.
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| Issue | Vol 54 No 2 (2025) | |
| Section | Review Article(s) | |
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| Postoperative Nursing intervention Transurethral resection of the prostate Meta-analysis | ||
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How to Cite
1.
Guo B. Clinical Application Effect of Postoperative Nursing Intervention on Patients Undergoing Transurethral Prostatectomy: A Systematic Review and Meta-Analysis. Iran J Public Health. 2025;54(2):285-296.
