The factors affecting occurrence of urethral stricture after transurethral resection of the prostate

Objectives: Urethral stricture is one of the complex subjects of urology in terms of high recurrence rates, patient care, treatment difficulties and follow-up. We aimed to evaluate factors associated with the occurrence of urethral stricture after TUR-P (Transurethral resection of the prostate) surgery.
Material and methods: In our clinic, 301 patients who underwent TUR-P surgery for benign prostatic hyperplasia (BPH) were analyzed retrospectively. The patients who developed urethral stricture after TUR-P were named Group-1, did not develop were named Group-2. In addition, the patients were compared in terms of demographic and perioperative data. 
Results: Urethral stricture was observed in 21 (6.97%) of the patients and not in 280 (93.03%) of them. There was no significant difference between the two groups in terms of age (p=0.913), resectoscope size (p=0.932), energy source type (p=0.932), energy source power (p=0.838), urethral catheter type (p=0.776), urethral catheter size (p=0.973), urethral catheter duration (p=0.797) and urethral catheter traction (p=0.887). Resection time was significantly higher in patients with urethral stricture (53.1±10.8 min vs. 42.2±9.7 min, p<0.001). The preoperative urinary tract infection (UTI) rate was significantly higher in patients with urethral stricture. (76.2% vs 40.0%, p=0.001). The optimum cut-off value for resection time associated with the risk of urethral stricture after TUR-P was 38.5 minutes, with an AUC of 0.812 (95% CI 0.738–0.885).
Conclusion: Prolonged resection time and even if treated, preoperative UTI increases the risk of urethral stricture after TUR-P surgery. However, if the resection time is not long, patients are more protected from developing urethral stricture.