What effect would a TURP, either previous to or after seed implantation, have on treatment?
In some patients, the presence of a previous TURP prevents a technically good implant. In the past, patients with a prior TURP had an increased risk of urinary incontinence of approximately 25% at six years. The majority of this incontinence was minor, requiring a simple pad. In the past several years changes in the pattern of seed placement have been done in these TURP patients with the hope of decreasing this risk. Since it takes some time to learn the results, patients with a prior TURP are advised that their risk of incontinence is higher. There are, of course, often very good alternative treatments (radical prostatectomy or external beam radiation). TURP after the implant also imparts a risk of incontinence. Therefore, a TURP in implant patients is not generally recommended. When a TURP is necessary after implant, someone who understands the problems associated with it should perform it.
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