The incidence of urethral stricture and bladder neck contracture with transurethral resection vs. holmium laser enucleation of prostate: A matched,dual-center study |
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| Authors: | Mohamed Elsaqa Mohamed Serag Navid Leenlani Moustafa Momtaz Elsawy Mostafa Sakr Tamer Abou Youssif Hazem Rashad Marawan M. El Tayeb |
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| Affiliation: | 1.Alexandria University Faculty of Medicine, Alexandria, Egypt; 2.Division of Urology, Department of Surgery, Baylor Scott & White Health, Temple, TX, United States; 3.Alabama College of Osteopathic Medicine, Dothan, AL, United States; 4.Darent Valley Hospital, Dartford, Kent, United Kingdom |
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| Abstract: | ![]()
IntroductionUrethral 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.MethodsA 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.ResultsThe 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 and HoLEP arms, 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%) had bipolar TURP, while two (5%) 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.ConclusionsThere 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.KEY MESSAGES- We compared TURP and HoLEP regarding their incidence of US or BNC with matching patients for age and prostate volume and identified possible risk factors.
- The US incidence was comparable, although the incidence within the TURP arm was higher with bipolar than monopolar TURP.
- The BNC incidence was 1.87% in the HoLEP arm, while none of the patients in the TURP arm developed BNC (statistically insignificant).
- Multivariate analysis showed that larger prostate volume and longer operative time were associated with higher risk of US/BNC.
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