Retrospective Assessment of Post-Transurethral Resection of the Prostate Complications in Benign Prostatic Hyperplasia Patients: Impact of Acute Urinary Retention

Cureus. 2024 Oct 23;16(10):e72223. doi: 10.7759/cureus.72223. eCollection 2024 Oct.

Abstract

Background Benign prostatic hyperplasia (BPH) is the most common urological condition affecting older men, leading to lower urinary tract symptoms (LUTS) and complications such as acute urinary retention (AUR), which can significantly impact quality of life. This study aims at comparing the postoperative outcomes and complication rates of monopolar transurethral resection of the prostate (TURP) in BPH patients with and without AUR. By examining the differences in postoperative outcomes, the study seeks to highlight the impact of AUR on complications such as UTIs, prolonged catheterization, and extended hospital stays, and assess the potential clinical implications for improving treatment strategies in these patients. Methodology An observational retrospective study was conducted at a tertiary care hospital in central India, over a period of two years. The study included 150 men aged 45 to 70 years with LUTS due to BPH, and participants were equally divided between two groups: Group A (AUR positive) and Group B (AUR negative). Wide-ranging assessments were performed on all patients, including history, physical examination, digital rectal examination, ultrasound, and post-void residual (PVR) urine assessment. Postoperative outcomes and complications were determined, and statistical analyses were conducted using Student's t-test with a level of significance of p < 0.05. Results The findings of the study indicated that patients in Group A, who experienced AUR, had significantly higher postoperative complications compared to Group B, who did not have AUR. Specifically, the mean complication rate was 60% in Group A compared to 30% in Group B. Common complications included urinary tract infections and prolonged hospital stays. In terms of urodynamic parameters, Group A exhibited a significantly lower maximum flow rate (Qmax) at 7.5 mL/s compared to 9.8 mL/s in Group B (p < 0.01). The average PVR volume was also notably higher in Group A at 150.4 mL, compared to 90.2 mL in Group B (p < 0.01). These differences highlight the impact of AUR on surgical outcomes. Conclusion The findings of this study highlight the increased risks of complications associated with AUR in patients undergoing monopolar TURP. These results underscore the need for careful patient selection and management strategies to optimize outcomes. Future research should focus on expanding the sample size and incorporating multicenter data to enhance the generalizability of the results. Additionally, further investigation into long-term outcomes and the effectiveness of different management protocols for patients with AUR will be essential for improving the quality of care in the management of BPH.

Keywords: acute urinary retention; benign prostatic hyperplasia; complications; lower urinary tract symptoms; transurethral resection of the prostate.