Incidence of urethral stricture and urinary incontinence after transurethral resection of the prostate.

Abstract

Background: Transurethral resection of the prostate (TURP) is the standard treatment for benign prostatic hyperplasia (BPH). The incidence of postoperative urethral stricture (US) and urinary incontinence remains clinically important, and their predictors are not fully established. This study aimed to determine the incidence of these complications and identify associated risk factors.

Materials and methods: This retrospective cohort study was conducted at Al-Zahra Hospital, Isfahan, Iran, between 2020 and 2023. A total of 110 male patients with BPH who underwent TURP and completed 6 months of postoperative follow-up were included. Baseline variables (age, prostate volume, and operative duration) were extracted from medical records. Complications were assessed at 6 months, specifically the occurrence of US, urinary incontinence, and the composite outcome defined as either stricture or incontinence. An independent samples t-test compared mean values between groups, and logistic regression was used to identify predictors.

Results: The mean age of patients was 68.2 ± 11.6 years, the mean prostate volume was 38.9 ± 10.3 mL, and the mean operative duration was 96.8 ± 17.4 min. The incidence of US was 9.1% (18.2 cases per 100 person-years), urinary incontinence 6.4% (12.7 cases per 100 person-years), and the composite outcome 15.5% (30.9 cases per 100 person-years). Patients with US had slightly lower age and smaller prostate volume but longer operative duration; none of these differences were statistically significant. Patients with urinary incontinence were significantly older (78.1 ± 9.4 vs. 67.5 ± 11.4 years, P = 0.018). Logistic regression confirmed age as an independent predictor of incontinence (odds ratio = 1.095, 95% confidence interval: 1.011-1.186, P = 0.025). No significant predictors were identified for stricture or the composite outcome.

Conclusion: The incidence of US and urinary incontinence after TURP was modest, with age emerging as a significant predictor of incontinence. Elderly patients undergoing TURP should be counseled about the increased risk of postoperative incontinence, and perioperative strategies may be needed to mitigate this risk.