Sekar Hariharasudhan, Palaniyandi Velmurugan, Krishnamoorthy Sriram, Kumaresan Natarajan
Department of Urology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.
Urol Ann. 2021 Oct-Dec;13(4):329-335. doi: 10.4103/UA.UA_165_19. Epub 2021 Oct 12.
Post-transurethral resection of prostate urethral stricture (PTS) is a well-documented delayed complication following transurethral resection of the prostate (TURP). The aim is to analyze various risk factors of PTS and see if the overall incidence is underreported.
A retrospective study was conducted in our institution between January 2017 and December 2018 in men who underwent TURP. Data obtained from the medical records department were analyzed. Statistical analysis was done using Fisher's exact test. A two-tailed < 0.05 is considered statistically significant.
Of the 447 men who underwent TURP, 57 developed PTS. Fifteen of 334 patients who underwent calibration before the procedure developed stricture compared to 42 of 137 without calibration ( < 0.01). There was a significantly lesser incidence of stricture with 24 Fr resectoscope compared with 26 Fr sheath ( < 0.04). Two patients with 24 Fr Foley and 30 of 35 (86%) patients with 22 Fr Foley catheter developed stricture of urethra. Distal bulbar urethra was the most common site of narrowing following TURP. Eighteen patients had Salvaris swab placed for traction and 12 patients required full-thigh traction, of which majority developed meatal stenosis.
TURP is one of the common surgical procedures performed by urologists. Meatitis and meatal stenosis, if included as complications of TURP, would increase the overall incidence of PTS. Factors such as the size of resectoscope sheath used, size of catheter inserted, placement of Salvaris swab traction, and preoperative calibration of urethra have a significant impact on the ultimate outcome.
经尿道前列腺电切术后尿道狭窄（PTS）是经尿道前列腺电切术（TURP）后一种有充分文献记载的延迟并发症。目的是分析PTS的各种危险因素，并查看总体发病率是否被低估。
2017年1月至2018年12月在我们机构对接受TURP的男性进行了一项回顾性研究。分析从病历科获得的数据。使用Fisher精确检验进行统计分析。双侧P < 0.05被认为具有统计学意义。
在447例接受TURP的男性中，57例发生了PTS。术前进行校准的334例患者中有15例发生狭窄，而未进行校准的137例患者中有42例发生狭窄（P < 0.01）。与26F鞘相比，使用24F电切镜时狭窄发生率明显更低（P < 0.04）。使用24F Foley导管的2例患者和使用22F Foley导管的35例患者中的30例（86%）发生了尿道狭窄。球部尿道远端是TURP后最常见的狭窄部位。18例患者放置了Salvaris拭子进行牵引，12例患者需要大腿全牵引，其中大多数发生了尿道口狭窄。
TURP是泌尿外科医生进行的常见手术之一。如果将尿道口炎和尿道口狭窄作为TURP的并发症包括在内，将增加PTS的总体发病率。所用电切镜鞘的大小、插入导管的大小、Salvaris拭子牵引的放置以及尿道的术前校准等因素对最终结果有重大影响。
