Management of post TURP strictures

Urethral stricture is a well-known complication after transurethral surgeries. The incidence of urethral stricture after transurethral resection of prostate (TURP) varies between 2.2 and 9.8%. Most of the cases present within 6 months of transurethral surgery. Presentation is likely with poor flow, urinary tract infection or acute retention.

A prospective study was undertaken from January 2010-June 2017 for the management of post TURP stricture. A total of 170 patients with stricture urethra due to TURP were studied.

The age of patients was 54-87 years (mean age 67.34). The mean preop Qmax was 6.1 ml (range 0-15). The length of stricture varied from very short in the proximal bulbar to pan urethral stricture. Out of 170, 94 were treated with dorsal approach, 71 with ventral approach and 5 with simultaneous distal dorsal, proximal ventral approach. Five patients underwent endoscopic procedure. Mean BMG length was 6.25 cm (4-8) and width was 1.5 cm (1.3-1.8). Overall success rate was 82.43%.

Urethral stricture is a well-known complication after transurethral surgeries. Post TURP can cause stricture at any part urethra. BMG mucosa Urethroplasty is the safe, feasible and offer long-term success in these patient and should be strongly considered over CIC and VIU. Ventral approach is best suited for proximal bulbar strictures close to membranous urethra. This is a continence preserving surgery.