Analysis of risk factors leading to postoperative urethral stricture and bladder neck contracture following transurethral resection of prostate

Huang, Tao; Jiang, Yu; Qi, Jun; Xu, Ding; Jian, Duan Liu; Ding, Jie; Ping, Zhu Yu

doi:10.1590/s1677-5538.ibju.2014.0500

Cited by 46 publications

(40 citation statements)

References 30 publications

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“…It is interesting to note that Tao et al [ 25 ] also recently reported that US is associated with slow resection rate. That study also found mucosal rupture of the urethra and continuous postoperative infection to be risk factors for US occurrence.…”

Section: Discussionmentioning

confidence: 98%

Urethral strictures after bipolar transurethral resection of prostate may be linked to slow resection rate

et al. 2017

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PurposeThis study aimed to determine the urethral stricture (US) rate and identify clinical and surgical risk factors associated with US occurrence after transurethral resection of the prostate using the bipolar Gyrus PlasmaKinetic Tissue Management System (PK-TURP).Materials and MethodsThis was an age-matched case-control study of US occurrence after PK-TURP. Retrospective data were collected from the hospital records of patients who had a minimum of 36 months of follow-up information. Among the data collected for analysis were prostate-specific antigen level, estimated prostate weight, the amount of prostate resected, operative time, history of urinary tract infection, previous transurethral resection of the prostate, and whether the PK-TURP was combined with other endourological procedures. The resection rate was calculated from the collected data. Univariate and multivariate analyses were performed to identify clinical and surgical risk factors related to US formation.ResultsA total of 373 patients underwent PK-TURP between 2003 and 2009. There were 13 cases of US (3.5%), and most of them (10 of 13, 76.9%) presented within 24 months of surgery. Most of the US cases (11 of 13, 84.6%) occurred at the bulbar urethra. Multivariable logistic regression analyses identified slow resection rate as the only risk factor significantly associated with US occurrence.ConclusionsThe US rate of 3.5% after PK-TURP in this study is comparable to contemporary series. A slow resection rate seems to be related to US occurrence. This should be confirmed by further studies; meanwhile, we must be mindful of this possibility when operating with the PK-TURP system.

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Section: Discussionmentioning

confidence: 98%

Urethral strictures after bipolar transurethral resection of prostate may be linked to slow resection rate

et al. 2017

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“…Many risk factors, including small prostate volume, higher International Prostate Symptom Score storage scores, preoperative uncontrolled infection, unsuitable resectoscope, large resection loop, extensive resection of the bladder neck, long operative time and postoperative Foley insertion have been shown to be associated with the risk of BNC. 7,9 The most reported risk factor is small prostate volume with overresection of the bladder neck. Over-resection of the bladder neck can lead to brosis or scarring of the bladder neck, which in turn leads to BNC.…”

Section: Discussionmentioning

confidence: 99%

“…5 Many risk factors have been associated with BNC, such as untreated preoperative urinary tract infection, small prostate volume, unsuitable resectoscope diameter, long operative time, history of prostatitis and postoperative Foley insertion. [5][6][7] The aim of the current study was to investigate the preoperative parameters associated with the occurrence of BNC after TURP or ThuP, and the difference in BNC incidence rates between TURP and ThuP.…”

Section: Introductionmentioning

confidence: 99%

Analysis of Risk Factors of Bladder Neck Contracture Following Transurethral Surgery of Prostate

Chen

Lin

Chow

et al. 2021

Preprint

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Backgrounds: The aim of the present study was to investigate the preoperative parameters associated with bladder neck contracture (BNC) after transurethral resection of the prostate (TURP) or Thulium vaporesection, vapoenucleation or enucleation of the prostate (ThuP) and to compare the incidence of BNC after TURP and ThuP. Methods: Between March 2008 and March 2020, 2,363 patients received TURP and 1,656 patients received ThuP at Mackay Memorial Hospital. A total of 62 patients developed BNC. These BNC patients were age-and operation-matched to 124 randomly sampled TURP/ThuP controls without BNC. Results: Multivariate analysis showed that when compared with patients without BNC, those with BNC had smaller prostates (43.0±18.95 ml vs 57.2±19.84 ml, p<0.001), lower resection weight (11.64±11.75 g vs 16.67±12.84 g, p=0.001), shorter operative times (43.0±30.9 min vs 57.2±34.5, p<0.001), and slower resection speed (0.124±0.081 g/min vs 0.151±0.952 g/min, p=0.041). A greater proportion of BNC patients had history of cerebrovascular accidents (11/62 vs 7/124, p=0.009), coronary artery disease(14/48 vs 16/108, p=0.03), chronic kidney disease (14/62 vs 11/124, p=0.01), and two or more comorbidities (29/62 vs 27/124, p=0.001). A ROC curve predicted that a prostate volume <42.9cm3 was associated with a notably higher rate of BNC. Conclusion: This study demonstrated that incidence of BNC was the same in TURP and ThuP and low prostate volume, low resection speed and ≥2 comorbidities were positively correlated with the development of BNC after TURP or ThuP.

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“…[24] Therefore one should be more attentive when making indication of TURP for small-sized prostates. [25] The authors have indicated that bladder neck incision performed at the end of TURP may decrease the risk of development of bladder neck contracture. [26] In our study, when one considers that median volume of resected prostates was 29 cm 3 , then median incidence rate of contracture was 5.2% which is within an acceptable range.…”

Section: Discussionmentioning

confidence: 99%

The outcomes of transurethral incision/resection of the prostate (TUIP/TURP) performed early after renal transplantation

Sarıer

Duman

Demir

et al. 2018

Turkish Journal of Urology

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Objective: In the early period after renal transplantation, urinary retention stemming from bladder outlet obstruction (BOO) may directly affect graft success. The aim of this study was to evaluate the early and long-term outcomes of transurethral resection of the prostate (TURP) and transurethral incision of prostate (TUIP) procedures performed in the first month following RT due to BOO. Material and methods:Between February 2009 and March 2016, 38 male patients underwent TURP/ TUIP due to BOO within the first 30 days of renal transplantation. The urodynamic and renal function assessment results of all patients were collected during the pre-and postoperative periods. All patients were followed up for a minimum of 12 months for short and long-term complications. The results were evaluated retrospectively. Results:The mean age of the patients who underwent operations was 59.2±12 years. The median duration of dialysis was 41 months (range 0-180). Before the operation the mean serum creatinine (sCr) level was 1.8±0.7 mg/dL, the mean total PSA level was 1.6±1.1 ng/mL. Of the voiding parameters, the mean Qmax and Qave were measured as 8.2±4.5 mL/sec and 4.6±2.5 mL/sec, respectively. The median post-micturition residual urine (PMR) was 105 mL (range 10-400). TURP/TUIP operations were performed at a median of 19 days (range 8-30) after renal transplantations. None of the patients experienced major complications. In the early postoperative period, 5 patients (13.1%) developed urinary tract infection. The mean decrease in sCr in the first month following TURP/TUIP was 1.4±0.4 mg/dL (p<0.001). The mean Qmax (22.4±11.1 mL/sec), and Qave (11.7±5.4 mL/sec) increased significantly (p<0.001), while the median PMR (15 mL, range 0-205) decreased significantly (p<0.001). The mean follow-up period after the procedure was 46.8±23.3 months. During the follow-up period, 3 (7.8%) patients suffered from urethral stricture and 2 (5.2%) patients from bladder neck obstruction. Conclusion:In the surgical treatment of urinary retention arising from BOO in the first month following renal transplantation, TURP/TUIP yield safe and successful results. In addition, regarding the short and long term outcomes, these procedures may be safely performed with low morbidity.

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Analysis of risk factors leading to postoperative urethral stricture and bladder neck contracture following transurethral resection of prostate

Cited by 46 publications

References 30 publications

Urethral strictures after bipolar transurethral resection of prostate may be linked to slow resection rate

Urethral strictures after bipolar transurethral resection of prostate may be linked to slow resection rate

Analysis of Risk Factors of Bladder Neck Contracture Following Transurethral Surgery of Prostate

The outcomes of transurethral incision/resection of the prostate (TUIP/TURP) performed early after renal transplantation

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