The effect of acute urinary retention on the results of transurethral resection of the prostate

Urologia. 2023 Nov;90(4):642-646. doi: 10.1177/03915603231189627. Epub 2023 Jul 25.

Abstract

Introduction: Acute urinary retention (AUR) is one of the most severe symptoms of Benign Prostatic Hyperplasia (BPH). There are some studies in the literature describing the risk factors for the development of AUR in BPH patients. However, the studies that summarize the effect of AUR on Transurethral resection of Prostate (TUR-P) surgery results are limited. The aim of this study is to assess the effect of AUR on TUR-P results.

Methods: Between 2018 and 2020, patients who underwent TUR-P for AUR or lower urinary tract symptoms (LUTS) were included in the study. The inclusion criteria were, men over 50 years old with a BPH diagnosis and who underwent monopolar TUR-P by a single surgeon. The exclusion criteria were; patients who had prostate cancer, multiple sclerosis, or neurogenic bladder were diagnosed or had previous lower urinary tract surgeries such as TUR-P, TUR-Bladder, Urethrotomy, had a chronic indwelling catheter, and patients who did not accept immediate TUR-P and preferred trial without catheter (TWOC) protocol. The age, PSA, prostate volume, pre- and post-operative flow rates, duration of hospitalization, and complications were recorded. Two groups were constituted for comparison such as AUR and Elective Group and p values <0.05 were considered significant.

Results: There were 14 and 46 patients for AUR and Elective Groups respectively. The age, pre-operative prostate volume, free and total PSA values, postoperative complication rate, and re-hospitalization rate were significantly higher in the AUR-Group. However, there were no differences between groups in terms of pre-operative medication, duration of hospitalization, and post-operative uroflow maximum flow rate.

Discussion: Patients who underwent TUR-P after AUR have a higher risk for complications and re-hospitalization. Care should be taken in these patients and patients should be warned about the risks.

Keywords: Acute urinary retention; benign prostate hyperplasia; postoperative complication; transurethral resection of prostate; urethral catheterization.

MeSH terms

  • Humans
  • Male
  • Middle Aged
  • Prostate / surgery
  • Prostate-Specific Antigen
  • Prostatic Hyperplasia* / complications
  • Prostatic Hyperplasia* / surgery
  • Transurethral Resection of Prostate* / adverse effects
  • Transurethral Resection of Prostate* / methods
  • Treatment Outcome
  • Urinary Retention* / etiology

Substances

  • Prostate-Specific Antigen