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

Abstract

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.