Urethral strictures (US) and bladder neck contracture (BNC) are common long-term complications of transurethral prostate surgery. We aimed to compare transurethral resection of the prostate (TURP) and holmium laser enucleation of the prostate (HoLEP) regarding incidence of US or BNC and identify possible risk factors.
A retrospective review of patients who underwent TURP and HoLEP with followup data of at least one year in two separate institutions was performed. The incidence of postoperative US or BNC in both groups was compared. Bivariate and multivariate analysis of risk factors in both cohorts with US or BNC were performed.
The study included 208 patients: 101 and 107 patients in the TURP and HoLEP arms, respectively. The two groups were matched for age and prostate size. Eight (7.92%) and five (4.72%) patients in the TURP arm and HoLEP arm, respectively, developed US (p=0.3423), while two (1.87%) patients in the HoLEP arm had BNC (p=0.2634). Of the eight patients with the US in the TURP arm, six (9.8%) patients had bipolar TURP, while two (5%) patients had monopolar TURP. Multivariate analysis showed that larger prostate volume (hazard ratio [HR] 1.22, 95% confidence interval [CI] 1.05, 1.41, p=0.0066) and longer operative time (HR 1.84, 95% CI 1.76, 1.93, p=0.0015) were associated with risk of US/BNC.
There is no significant difference between TURP and HoLEP regarding incidence of US or BNC, although there is a tendency towards a higher rate of US associated with bipolar TURP. Increased prostate volume and operative time are possible risk factors.
Canadian Urological Association journal = Journal de l'Association des urologues du Canada. 2022 Aug 30 [Epub ahead of print]
Mohamed Elsaqa, Mohamed Serag, Navid Leenlani, Moustafa Momtaz Elsawy, Mostafa Sakr, Tamer Abou Youssif, Hazem Rashad, Marawan M El Tayeb
Alexandria University Faculty of Medicine, Alexandria, Egypt., Alabama College of Osteopathic Medicine, Dothan, AL, United States., Division of Urology, Department of Surgery, Baylor Scott & White Health, Temple, TX, United States.