Urethral and bladder neck stenosis after thulium laser enucleation of the prostate: Analysis of risk factors in a series of 1003 patients.

Publisher: Blackwell Pub Country of Publication: Germany NLM ID: 0423506 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1439-0272 (Electronic) Linking ISSN: 03034569 NLM ISO Abbreviation: Andrologia Subsets: MEDLINE

Publication: : Berlin : Blackwell Pub.
Original Publication: Berlin, Grosse

Prostatic Hyperplasia*/etiology ; Transurethral Resection of Prostate*/adverse effects ; Urethral Stricture*/complications ; Urethral Stricture*/etiology ; Urinary Bladder Neck Obstruction*/epidemiology ; Urinary Bladder Neck Obstruction*/etiology ; Urinary Bladder Neck Obstruction*/surgery; Aged ; Constriction, Pathologic/epidemiology ; Constriction, Pathologic/etiology ; Humans ; Lasers ; Male ; Prostate ; Retrospective Studies ; Risk Factors ; Thulium ; Treatment Outcome ; Urinary Bladder

We assessed the incidence and risks factors of bladder neck and urethral stenosis after Thulium laser enucleation of the prostate. Patients who underwent surgery at two centres were retrospectively reviewed (December 2014-June 2020). Exclusion criteria: previous urethral/prostatic surgery, pelvic irradiation, prostate cancer, neurogenic bladder, history of bladder neck and urethral stenosis, concomitant transurethral surgery, active urinary tract infection. Significant variables at univariate analysis (p < 0.05) were included in a multivariate logistic regression analysis to establish their association with bladder neck/urethral stenosis. One thousand and three patients were included. Median age was 69.0 (63.0-75.0) years. Median prostate volume was 65.0 (46.3-82.0) ml. Median follow-up was 31 (25-75) months. Thirty patients (2.99%) developed bladder neck stenosis [median time after surgery: 15 (11-17.75) months], 50 patients (4.98%) urethral stenosis [median time after surgery: 9 (7-11) months]. Men with bladder neck and urethral stenosis had significantly smaller prostate volume (median volume 43.5 ml vs. 66.0 ml, p = 0.008, and 52.0 ml vs. 66.0 ml, p = 0.009, respectively). At multivariable analysis, short surgical time predicted for bladder neck stenosis (OR 0.973; 95% CI 0.957-0.994, p = 0.002), and re-catheterization (OR 3.956; 95% CI 1.867-8.382, p < 0.001) for urethral stenosis, whereas prostate volume was significantly associated with a lower incidence of US (OR 0.984, 95% CI 0.972-0.998, p = 0.03).
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Keywords: ThuLEP; benign prostatic hyperplasia; bladder neck stenosis; postoperative complications; urethral stenosis

8RKC5ATI4P (Thulium)

Date Created: 20220705 Date Completed: 20220907 Latest Revision: 20220907

20231215

10.1111/and.14523

35789109