Modified transurethral resection of the prostate for the management of BPH-related refractory lower urinary tract symptoms in patients with a history of pelvic fracture urethral injury reconstruction.

To evaluate the impact of a modified transurethral resection of prostate (mTURP) in patients with a history of pelvic fracture urethral injury (PFUI) status post-urethroplasty, and subsequent lower urinary tract symptoms (LUTS) refractory to medical therapy caused by benign prostatic hyperplasia (BPH).

Five patients were identified with a history of PFUI and a successful reconstruction of the urethra, who developed severe LUTS. After maximal medical therapy failed, these patients underwent a mTURP. Their continence status and voiding parameters were recorded before and after surgery.

Significant improvements in both post-void residual (172 ± 137.36 mL vs. 26.6 ± 24.44 mL), p = 0.026, and International Prostatic Symptom Score (23.6 ± 4.82 vs. 7.6 ± 4.30), p = 0.002 were observed in the study. Although maximum flow rate was not statistically significant, there was an overall improvement in Qmax in all patients (8.92 ± 3.71 vs. 16.78 ± 6.44 mL/sec). Furthermore, all patients remained continent after this modified intervention.

Our modified TURP provides an adjunctive option in the management of severe LUTS secondary to BPH in patients with a history of PFUI urethroplasty who are refractory to medical management. In our experience, the patients experienced a lasting response with no incontinence.

International urology and nephrology. 2019 Sep 06 [Epub ahead of print]

Kirtishri Mishra, Cristina Baeza, Laura Bukavina, Reynaldo G Gómez

Urology Institute, University Hospitals, Cleveland Medical Center, Cleveland, OH, USA., Urology Service, Hospital del Trabajador, Ramón Carnicer 185, Providencia, Santiago, Región Metropolitana Chile, Chile., Urology Service, Hospital del Trabajador, Ramón Carnicer 185, Providencia, Santiago, Región Metropolitana Chile, Chile. .

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