Therapeutic Efficacy and Complication Profile of Monopolar Transurethral Resection of the Prostate (TURP) in the Management of Bladder Outlet Obstruction.

BACKGROUND

Bladder outlet obstruction (BOO) due to benign prostatic hyperplasia (BPH) is a common urological condition in aging men, often requiring surgical intervention for symptom relief.

OBJECTIVE

To evaluate the therapeutic efficacy and complication profile of monopolar transurethral resection of the prostate (TURP) in patients with BOO.

METHODOLOGY

This descriptive observational study was conducted at the Department of Urology, Hayatabad Medical Complex, Peshawar, and Akhtar Saeed Trust Hospital, Lahore, from August 2022 to July 2024. A total of 518 male patients aged ≥ 50 years with BOO secondary to BPH underwent monopolar TURP. Preoperative, intraoperative, and postoperative variables were collected using a standardized proforma. Functional outcomes, including International Prostate Symptom Score (IPSS), maximum urinary flow rate (Qmax), and post-void residual volume (PVR), were assessed at baseline and one, six, and 12 months postoperatively. Complication rates and predictors were also analyzed.

RESULTS

Mean age was 68.42 ± 7.85 years. Significant improvement was observed in IPSS (from 23.74 ± 4.96 to 7.82 ± 2.81), Qmax (from 7.89 ± 2.11 mL/sec to 17.50 ± 4.67 mL/sec), and PVR (from 126.40 ± 34.70 mL to 30.10 ± 16.87 mL) at 12 months (p < 0.001). Early complications included hematuria in 42 patients (8.11%), UTI in 61 (11.78%), and TUR syndrome in six (1.16%). Late complications included urethral stricture (3.67%) and bladder neck contracture (2.12%).

CONCLUSION

Monopolar TURP is an effective and safe surgical option for managing BOO due to BPH in resource-limited settings.