Bladder neck stenosis after transurethral resection of prostate: does size matter?

Abstract

AIM:

To understand the risk factors associated with the incidence of bladder neck stenosis (BNS) after transurethral prostate surgery.

PATIENTS AND METHODS:

We retrospectively reviewed 900 patients who underwent transurethral prostate surgery over a 4-year period. The mean age of the men was 72.3 (47-94) years. The specific outcome data assessed related to BNS, including type of operation performed, resected tissue weight and history of previous surgery in the lower urinary tract.

RESULTS:

29 (3.4%) patients developed BNS at a mean of 10.3 (3-33) months, with a mean resected prostatic tissue weight of 11+/-3.7 g. Four of the 29 patients with BNS were treated with bladder neck resection and re-stenosed. Fifty-four men underwent bladder neck incision for small prostates with a high bladder neck, measured by digital rectal examination and assessed cystoscopically, with no BNS. All the remaining patients from our series did not have a BNS, with a mean resected weight of 28+/-8.9 g, which is statistically greater than in the BNS group (p<0.05, unpaired t test).

CONCLUSIONS:

BNS after transurethral prostate surgery is a significant problem. It is clear from our study that resection in small prostates with no sign of a high bladder neck will increase the development of BNS. Thus, small prostates should be managed by an initial bladder neck incision, even if the bladder neck is not high.

• Authors: W Al-Singary, M Arya, H R H Patel
• Journal: Urologia internationalis (Urol Int) Vol. 73 Issue 3 Pg. 262-5 ( 2004) ISSN: 0042-1138 [Print] Switzerland
• PMID: 15539848 (Publication Type: Journal Article)
• Copyright: copyright 2004 S. Karger AG, Basel

Topics

• Aged
• Aged, 80 and over
• Constriction, Pathologic
• Humans
• Male
• Middle Aged
• Transurethral Resection of Prostate (adverse effects)
• Treatment Outcome
• Urinary Bladder (pathology)
• Urinary Bladder Neck Obstruction (etiology, prevention & control)