Simultaneous transurethral resection of the prostate and bladder tumor: a safety and efficacy analysis

The safety of simultaneous transurethral resection of the prostate (TUR-P) and bladder tumor removal in patients with benign prostatic hyperplasia (BPH) and bladder cancer remains unclear. The purpose of this study is to find out how TUR-P affects the recurrence, progression, and prostatic urethral invasion in patients with NMIBC (non-muscle invasive bladder cancer) and BPH.

We performed a retrospective analysis of bladder cancer patients treated between 2010 and 2023. Among them, 49 patients received either TUR-P alone or in conjunction with transurethral bladder tumor resection (TUR-B), while an additional 49 patients comprised the control group. We examined recurrence, progression, and invasion of the prostatic urethra. Statistical analyses included independent t-tests, Kaplan-Meier analysis, and Chi-square testing, with significance set at p < 0.001.

No significant difference in recurrence was observed between the control (73.5%) and TUR-P (65.3%) groups (p = 0.769). Progression was observed in 6.1% of the control group and 4.2% of the TUR-P group (p = 0.663). In the TUR-P group, one patient (2%) had prostatic urethral invasion; however, none in the control group did (p > 0.05). The recurrence rates increased more rapidly in the control and TUR-P-only cohorts than in the TUR-P + TUR-B cohort.

Transurethral resection of the prostate in NMIBC patients with BPH is safe and does not result in increased recurrence, progression, or invasion of the prostatic urethra. This technique reduces bladder outlet obstruction without significantly impacting oncologic outcomes. Large-scale, multicenter, prospective studies are required to validate these findings and further evaluate the long-term oncologic and functional outcomes of this combined surgical approach.