INCIDENCE OF URETHRAL STRICTURE FOLLOWING BIPOLAR TRANSURETHRAL RESECTION OF PROSTATE

S  INAMULLAH; F KHAN

doi:10.54112/bcsrj.v2024i1.944

Authors

S INAMULLAH Department of Urology, Lady Reading Hospital Peshawar KPK, Pakistan
F KHAN Department of Urology, Lady Reading Hospital Peshawar KPK, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v2024i1.944

Keywords:

Benign prostatic hyperplasia, Bipolar transurethral resection of the prostate, Urethral stricture, Meatal caliber, Risk factors, Postoperative complications.

Abstract

Benign prostatic hyperplasia (BPH) is a prevalent condition among older men, often treated with transurethral resection of the prostate (TURP). Bipolar TURP (B-TURP) has gained popularity due to its reduced risk of complications compared to monopolar TURP. However, postoperative urethral stricture remains a significant concern. Objective: This study aims to evaluate the incidence and risk factors associated with urethral stricture following B-TURP in a cohort of patients from a tertiary care center at the Urology Department, Lady Reading Hospital Peshawar KPK, Pakistan. Methods: This prospective study analyzed 136 patients who underwent B-TURP. Patient demographics, clinical parameters, perioperative details, and postoperative complications were recorded. Statistical analyses were performed to identify factors significantly associated with urethral stricture development. Results: The incidence of urethral stricture was 5.9%. A smaller metal caliber was significantly associated with stricture formation (mean caliber 25 Fr in patients with strictures vs. 28 Fr without; P = 0.001). Other factors such as prostate volume, diabetes mellitus, resectoscope sheath size, resection time, capsular perforation, and perioperative complications did not show a significant correlation with stricture development. Conclusion: Urethral stricture following B-TURP is relatively uncommon, with meatal caliber being an important predictor of risk. These findings align with recent literature, highlighting the importance of preoperative and perioperative factors in managing and mitigating the risk of strictures. Further, multi-center studies are needed to validate these results and explore additional preventive measures.

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References

Ückert S, Kedia GT, Tsikas D, Simon A, Bannowsky A, Kuczyk MA. Emerging drugs to target lower urinary tract symptomatology (LUTS)/benign prostatic hyperplasia (BPH): focus on the prostate. World journal of urology. 2020;38:1423-35.

Sciacqua L, Vanzulli A, Di Meo R, Pellegrino G, Lavorato R, Vitale G, et al. Minimally invasive treatment in benign prostatic hyperplasia (BPH). Technology in Cancer Research & Treatment. 2023;22:15330338231155000.

Koudonas A, Anastasiadis A, Tsiakaras S, Langas G, Savvides E, Mykoniatis I, et al. Overview of current pharmacotherapeutic options in benign prostatic hyperplasia. Expert Opinion on Pharmacotherapy. 2023;24(14):1609-22.

Hughes T, Harper P, Somani BK. Treatment Algorithm for Management of Benign Prostatic Obstruction: An Overview of Current Techniques. Life. 2023;13(10):2077.

Castellani D, Wroclawski ML, Pirola GM, Gauhar V, Rubilotta E, Chan VW-S, et al. Bladder neck stenosis after transurethral prostate surgery: a systematic review and meta-analysis. World Journal of Urology. 2021;39(11):4073-83.

Fuschi A, Asimakopoulos AD, Scalzo S, Martoccia A, Al Salhi Y, Suraci PP, et al. B-TURP versus HoLEP: Peri-Operative Outcomes and Complications in Frail Elderly (> 75 yo) Patients: A Prospective Randomized Study. Biomedicines. 2022;10(12):3212.

Fogaing C, Alsulihem A, Campeau L, Corcos J. Is early surgical treatment for benign prostatic hyperplasia preferable to prolonged medical therapy: pros and cons. Medicina. 2021;57(4):368.

Wang J-W, Man L-B. Transurethral resection of the prostate stricture management. Asian journal of andrology. 2020;22(2):140-4.

Saputra D, Agil A, Mustafa A. Predictors of Urethral Stricture After Transurethral Resection of the Prostate Procedure. Majalah Kedokteran Bandung. 2023;55(2):106-10.

Sugihara T, Yasunaga H, Horiguchi H, Nakamura M, Nishimatsu H, Kume H, et al. In-hospital outcomes and cost assessment between bipolar versus monopolar transurethral resection of the prostate. Journal of endourology. 2012;26(8):1053-8.

Pirola GM, Castellani D, Lim EJ, Wroclawski ML, Le Quy Nguyen D, Gubbiotti M, et al. Urethral stricture following endoscopic prostate surgery: a systematic review and meta-analysis of prospective, randomized trials. World Journal of Urology. 2022;40(6):1391-411.

Mbaeri TU, Abiahu JA, Obiesie EA, Odo C, Oranusi KC, Nwofor AME, et al. Assessment of complications of transurethral resection of the prostate using clavien‑dindo classification in South Eastern Nigeria. Nigerian Journal of Surgery. 2020;26(2):142-6.

Kachrilas S, Bourdoumis A, Karaolides T, Nikitopoulou S, Papadopoulos G, Buchholz N, et al. Current status of minimally invasive endoscopic management of ureteric strictures. Therapeutic advances in urology. 2013;5(6):354-65.

Mannem SR, Mallikarjuna C, Bhavatej E, Taif NBM, Ravichander O, Syed MG. Incidence of urethral stricture following bipolar transurethral resection of the prostate: A single-centre study. Indian Journal of Urology. 2022;38(2):146-50.

Mao X, Zhou Z, Cui Y, Zhang Y, Yang M. Outcomes and complications of bipolar vs. monopolar energy for transurethral resection of bladder tumours: a systematic review and meta-analysis of randomized controlled trials. Frontiers in Surgery. 2021;8:583806.