Impact of Acute Urinary Retention on the Early and Late Outcomes of Transurethral Resection of the Prostate.
TL;DR
AUR before TURP is associated with longer hospitalization, higher early postoperative complication rates, and poorer functional outcomes, while preoperative urodynamic assessment and individualized postoperative follow-up may help optimize surgical results in this patient group.
Abstract
Background
Transurethral resection of the prostate (TURP) is the gold standard surgical treatment for benign prostatic hyperplasia (BPH), but postoperative outcomes may differ in patients presenting with acute urinary retention (AUR).
Aim
This study aimed to evaluate the impact of AUR on postoperative outcomes and complications in patients undergoing TURP for BPH.
Methods
This retrospective study included 398 male patients who underwent TURP between January 2020 and June 2024. We categorized the patients into two groups: those we operated on for lower urinary tract symptoms (LUTS) and those for AUR. Demographic data, prostate volume, serum prostate-specific antigen (PSA), maximum urinary flow rate (Qmax), post-void residual volume (PVR), International Prostate Symptom Score (IPSS), length of hospital stay, and postoperative complications were analyzed. Complications were classified according to the Clavien-Dindo system. Statistical analysis was performed using Student's t-test and Chi-square tests, with P < 0.05 considered significant.
Results
A total of 398 patients were included in the study, comprising 237 who underwent TURP for LUTS and 161 for AUR. The AUR group demonstrated significantly higher prostate volume ( P = 0.03), elevated PSA levels ( P < 0.001), longer hospital stay ( P = 0.001), and a higher early complication rate ( P < 0.001). The majority of these complications were recurrent AUR. Both groups showed significant postoperative improvement in Qmax and IPSS; however, patients with AUR had lower postoperative Qmax ( P < 0.001) and higher PVR ( P < 0.001). At six months, urethral stricture occurred more frequently in the LUTS group ( P = 0.025).
Conclusion
AUR before TURP is associated with longer hospitalization, higher early postoperative complication rates, and poorer functional outcomes. Preoperative urodynamic assessment and individualized postoperative follow-up may help optimize surgical results in this patient group.