Urethral dilation prior to surgery for benign prostatic hyperplasia (BPH) may decrease the likelihood of urethral stricture following the procedure, investigators reported at the International Continence Society’s 2022 annual meeting (ICS 2022) in Vienna, Austria.
Yeong Uk Kim, MD, and colleagues from the Department of Urology at the Yeungnam University College of Medicine in South Korea, conducted a retrospective study that included 651 men who underwent transurethral resection of the prostate for BPH. The cohort consisted of 295 men who underwent urethral dilation using a 28Fr dilator prior to the procedure and immediately before insertion of the resectoscope (dilation arm) and 356 who did not (control arm). The dilation and control arms were similar with respect to clinical variables such as age, body mass index, serum PSA level, prostate volume, preoperative uroflowmetry (peak flow rate, voiding volume, and post-void residual), International Prostate Symptom Score, operation time, and duration of catheterization.
The investigators assessed for urethral stricture by cystoscopy. They evaluated patients at 1 month, 3 months, and 6 months post-procedure.
Urethral stricture occurred in 12 (4.1%) patients in the urethral dilation group compared with 31 (8.7%) patients in the control group, Dr Kim and colleagues reported.
The mean duration of urethral stricture was 137.5 days. The mean length of the urethral strictures was 8.1 mm. Of the 43 urethral strictures, 21 occurred in the urethral meatus, 18 in the bladder neck, and 4 in the bulbous urethra, according to the investigators.
“The study demonstrated that preoperative urethral dilation decreased the incidence of urethral stricture after transurethral resection of the prostate cancer,” the authors concluded.
Kim Y, Ha J, Lee R, et al. Effect of routinely preoperative urethral dilation to prevent urethral stricture after transurethral resection of the prostate for benign prostatic hyperplasia. Presented at: ICS 2022, September 7-10, Vienna, Austria. Abstract 55.