Incidence of urethral stricture following bipolar transurethral resection of prostate: A single-center study

Abstract

Introduction: Bipolar transurethral resection of the prostate (B-TURP) is a commonly performed procedure, although it has not yet surpassed the gold standard monopolar TURP. The incidence and contributing factors to the development of urethral stricture following B-TURP are still a matter of debate and were analyzed in the present study. Methods: This prospective study evaluated patients who underwent B-TURP. Demographic characteristics, clinical data, and data on other specific investigations were analyzed. B-TURP was performed using an Olympus TURis bipolar system. Patients were followed up for 6 months with the International Prostate Symptom Score (IPSS), peak flow rate (Q-max), and residual urine estimation. Urethral stricture was defined as narrowing of the urethral lumen requiring instrumentation to improve the urinary flow rate. Results: A total of 352 patients were enrolled, with a mean age of 67 ± 8.6 years. The mean preoperative IPSS, prostate volume, and Q-max were 21 ± 4, 58.8 ± 31.7 cm3, and 8 ± 3 mL/sec, respectively. The mean meatal caliber was 28 ± 2 Fr. In 209 patients (59.4%), B-TURP was performed using a 24-Fr resectoscope, while in the remaining 143 (40.6%), a 26-Fr resectoscope was used. The mean resection times with the 24-Fr and 26-Fr resectoscopes were 36.5 ± 19.8 min and 63.5 ± 30 min, respectively. Urethral strictures were identified in 15 patients, with an incidence of 4.3%. Mean meatal caliber was significantly related to the risk of stricture formation (P = 0.001). Conclusions: The incidence of urethral stricture after B-TURP was 4.3%. We found that small meatal caliber was associated with an increased risk of urethral stricture following B-TURP.