The incidence of urethral stricture and bladder neck contracture with transurethral resection vs. holmium laser enucleation of prostate

A matched, dual-center study

Authors

  • Mohamed Elsaqa Faculty of Medicine, Alexandria University, Egypt; Division of Urology, Department of Surgery, Baylor Scott & White Health, Temple, Texas.
  • Mohamed Serag Alexandria University Faculty of Medicine, Alexandria, Egypt
  • Navid Leelani Alabama College of Osteopathic Medicine, Dothan, Alabama
  • Moustafa Momtaz Elsawy Alexandria University Faculty of Medicine, Alexandria, Egypt; Darent Valley Hospital, Dartford, Kent, UK
  • Mostafa Sakr Alexandria University Faculty of Medicine, Alexandria, Egypt
  • Tamer Abou Youssif Alexandria University Faculty of Medicine, Alexandria, Egypt
  • Hazem Rashad Alexandria University Faculty of Medicine, Alexandria, Egypt
  • Marawan M. El Tayeb Division of Urology, Department of Surgery, Baylor Scott & White Health, Temple, Texas.

DOI:

https://doi.org/10.5489/cuaj.7967

Keywords:

TURP; HoLEP; Urethra; Bladder neck contracture; Complications

Abstract

Introduction: 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.

Methods: 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.

Results: 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 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.

Conclusions: 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.

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Published

2022-08-30

How to Cite

Elsaqa, M., Serag, M. ., Leelani, N., Elsawy, M. M., Sakr, M. ., Abou Youssif, T. ., Rashad, H. ., & El Tayeb, M. M. . (2022). The incidence of urethral stricture and bladder neck contracture with transurethral resection vs. holmium laser enucleation of prostate : A matched, dual-center study. Canadian Urological Association Journal, 17(1), E35–8. https://doi.org/10.5489/cuaj.7967

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Section

Original Research