Skip to main content

Advertisement

Log in

Impact of asymptomatic prostatitis on re-operations due to urethral stricture or bladder neck contracture developed after TUR-P

  • Urology – Original Paper
  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the relationship between pathologically proven prostatic inflammation (PI) and re-operation rates due to urethral stricture (US) or bladder neck contracture (BNC) after transurethral resection of prostate (TUR-P).

Materials and methods

We have retrospectively reviewed the data of 917 consecutive TUR-P cases. Eligible patients (n = 276) were grouped with respect to presence of PI on TUR-P pathology; Group1: PI (+) (n = 67, 24.3%), and Group2: PI (−) (n = 209, 75.7%). The “re-operation” was defined as internal urethrotomy or bladder neck resection performed for BNC or US. Groups were compared with respect to descriptive data and need for re-operation. Logistic regression analysis was performed to estimate the independent risk factors for the development of BNC and US. P values under 0.05 were considered significant.

Results

Of the patients, 38 (13.8%) needed re-operation while 238 (86.2%) did not. The re-operation rate in Group1 was significantly higher than Group2 (29.8 vs. 8.6%, P < 0.001). In logistic regression analysis, duration of initial TUR-P and PI were found to be independent risk factors for development of BNC or US after TUR-P.

Conclusions

Prostatic inflammation on TUR-P pathology is an independent variable affecting the development of US or BNC. Our results should be supported by prospective studies including higher number of patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Hoffmann R (2005) Transurethrale resektion (TURP) und transurethrale ınzision (TUIP) der prostata. In: Hoffmann R (ed) Endoskopische Urologie. Springer, Heidelberg, pp 50–84

    Chapter  Google Scholar 

  2. Smith RD, Patel A (2011) Transurethral resection of the prostate revisited and updated. Curr Opin Urol 21(1):36–41

    Article  PubMed  Google Scholar 

  3. Madersbacher S, Alivizatos G, Nordling J, Sanz CR, Emberton M, de la Rosette JJ (2004) EAU 2004 Guidelines on assessment, therapy and follow-up of men with lower urinary tract symptoms suggestive of benign prostatic obstruction (BPH guidelines). Eur Urol 46(5):547–554

    Article  PubMed  Google Scholar 

  4. Madersbacher S, Lackner J, Brossner C, Röhlich M, Stancik I, Willinger M, Schatzl G (2005) Re-operation, myocardial infarction and mortality after transurethral and open prostatectomy: a nation-wide, long-term analysis of 23,123 cases. Eur Urol 47(4):499–504

    Article  PubMed  Google Scholar 

  5. Michielsen DP, Coomans D (2010) Urethral strictures and bipolar transurethral resection in saline of the prostate: fact or fiction? J Endourol 24(8):1333–1337

    Article  PubMed  Google Scholar 

  6. Rassweiler J, Teber D, Kuntz R, Hofmann R (2006) Complications of transurethral resection of the prostate (TURP)—incidence, management, and prevention. Eur Urol 50(5):969–980

    Article  PubMed  Google Scholar 

  7. Lee YH, Chiu AW, Huang JK (2005) Comprehensive study of bladder neck contracture after transurethral resection of prostate. Urology 65(3):498–503

    Article  PubMed  Google Scholar 

  8. Ruszat R, Wyler SF, Seitz M, Lehmann K, Abe C, Bonkat G, Reich O, Gasser TC, Bachmann A (2008) Comparison of potassium-titanyl-phosphate laser vaporization of the prostate and transurethral resection of the prostate: update of a prospective non-randomized two-centre study. BJU Int 102(10):1432–1439

    PubMed  Google Scholar 

  9. Schröder FH, Carter HB, Wolters T, van den Bergh RC, Gosselaar C, Bangma CH, Roobol MJ (2007) Early detection of prostate cancer in 2007. Part 1: PSA and PSA kinetics. Eur Urol 53(3):468–477

    Article  PubMed  Google Scholar 

  10. Keetch DW, Catalona WJ, Smith DS (1994) Serial prostatic biopsies in men with persistently elevated serum prostate specific antigen values. J Urol 151(6):1571–1574

    PubMed  CAS  Google Scholar 

  11. Djavan B, Ravery V, Zlotta A, Dobronski P, Dobrovits M, Fakhari M et al (2001) Prospective evaluation of prostate cancer detected on biopsies 1, 2, 3 and 4: when should we stop? J Urol 166(5):1679–1683

    Article  PubMed  CAS  Google Scholar 

  12. Tan N, Lane BR, Li J, Moussa AS, Soriano M, Jones JS (2008) Prostate cancers diagnosed at repeat biopsy are smaller and less likely to be high grade. J Urol 180(4):1325–1329

    Article  PubMed  Google Scholar 

  13. Gilling PJ, Mackey M, Cresswell M, Kennett K, Kabalin JN, Fraundorfer MR (1999) Holmium laser versus transurethral resection of the prostate: a randomized prospective trial with 1-year followup. J Urol 162(5):1640–1644

    Article  PubMed  CAS  Google Scholar 

  14. Borboroglu PG, Kane CJ, Ward JF, Roberts JL, Sands JP (1999) Immediate and postoperative complications of transurethral prostatectomy in the 1990s. J Urol 162:1307–1310

    Article  PubMed  CAS  Google Scholar 

  15. Kuntz RM, Ahyai S, Lehrich K, Fayad A (2004) Transurethral holmium laser enucleation of the prostate versus transurethral electrocautery resection of the prostate: a randomized prospective trial in 200 patients. J Urol 172(3):1012–1016

    Article  PubMed  Google Scholar 

  16. Muzzonigro G, Milanese G, Minardi D, Yehia M, Galosi AB, Dellabella M (2004) Safety and efficacy of transurethral resection of prostate glands up to 150 ml: a prospective comparative study with 1 year of followup. J Urol 172(2):611–615

    Article  PubMed  Google Scholar 

  17. Nickel JC, Downey J, Young I, Boag S (1999) Asymptomatic inflammation and/or infection in benign prostatic hyperplasia. BJU Int 84(9):976–981

    Article  PubMed  CAS  Google Scholar 

  18. McNaughton-Collins M, Stafford RS, O’Leary MP, Barry MJ (1998) How common is prostatitis? A national survey of physician visits. J Urol 159(4):1224–1228

    Article  Google Scholar 

  19. Cotran RS, Kumar V, Robbins SL (1999) Prostatitis. In: Robbins SL (ed) Robbins’ pathologic basic of disease, 6th edn. WB Saunders, Philadelphia, pp 1025–1027

    Google Scholar 

  20. True LD, Berger RE, Rothman I, Ross SO, Krieger JN (1999) Prostate histopathology in chronic prostatitis/chronic pelvic pain syndrome, a prospective biopsy study. J Urol 162(6):2014–2018

    Article  PubMed  CAS  Google Scholar 

  21. Zhang W, Sesterhenn IA, Connelly RR, Mostofi FK, Moul JW (2000) Inflammatory infiltrate (prostatitis) in whole mounted radical prostatectomy specimens from black and white patients is not etiology for radical differences in prostate specific antigen. J Urol 163(1):131–136

    Article  PubMed  CAS  Google Scholar 

  22. McNeal JE (1968) Regional morphology and pathology of the prostate. Am J Clin Pathol 49(3):347–357

    PubMed  CAS  Google Scholar 

  23. Abdel-Meguid TA, Mosli HA, Al-Maghrabi JA (2009) Prostate inflammation. Association with benign prostatic hyperplasia and prostate cancer. Saudi Med J 30(12):1563–1567

    PubMed  Google Scholar 

  24. Kwak C, Ku JH, Kim T, Park DW, Choi KY, Lee E, Lee SE, Lee C (2003) Effect of subclinical prostatic inflammation on serum PSA levels in men with clinically undetectable prostate cancer. Urology 62(5):854–859

    Article  PubMed  Google Scholar 

  25. Okada K, Kojima M, Naya Y, Kamoi K, Yokoyama K, Takamatsu T, Miki T (2000) Correlation of histological inflammation in needle biopsy specimens with serum prostate- specific antigen levels in men with negative biopsy for prostate cancer. Urology 55(6):892–898

    Article  PubMed  CAS  Google Scholar 

  26. Gümüş BH, Neşe N, Gündüz MI, Kandiloglu AR, Ceylan Y, Büyüksu C (2004) Does asymptomatic inflammation increase PSA? A histopathological study comparing benign and malignant tissue biopsy specimens. Int Urol Nephrol 36(4):549–553

    Article  PubMed  Google Scholar 

  27. Sherz HC, Kaplan GW (1990) Etiology, diagnosis and management of urethral strictures in children. Urol Clin North Am 17(2):389–394

    Google Scholar 

  28. Jorgensen PE, Weis N, Bruun E (1986) Etiology of urethral stricture following transurethral prostatectomy. A retrospective study. Scand J Urol Nephrol 20(4):253–255

    Article  PubMed  CAS  Google Scholar 

  29. Herrando C, Batista JE, Chechile G, López DML, Vicente J (1994) Bladder neck sclerosis after transurethral resection of the prostate. “Study Group of the Puigvert Foundation”. Actas Urol Esp 18(2):85–89

    PubMed  CAS  Google Scholar 

  30. Hammarsten J, LindqvistK SunzelH (1989) Urethral strictures following transurethral resection of the prostate. The role of the catheter. Br J Urol 63(4):397–400

    Article  PubMed  CAS  Google Scholar 

  31. Schultz A, Bay-Nielsen H, Bilde T, Christiansen L, Mikkelsen AM, Steven K (1989) Prevention of urethral stricture formation after transurethral resection of the prostate: a controlled randomized study of Otis urethrotomy versus urethral dilation and the use of the polytetrafluoroethylene coated versus the uninsulated metal sheath. J Urol 141(1):73–75

    PubMed  CAS  Google Scholar 

  32. Tuncel A, Uzun B, Eruyar T, Karabulut E, Seckin S, Atan A (2005) Do prostatic infarction, prostatic inflammation and prostate morphology play a role in acute urinary retention? Eur Urol 48(2):277–283

    Article  PubMed  Google Scholar 

  33. Balbay MD, Ergen A, Sahin A, Lekili M, Ulucay S, Karaağaoğlu E (1992) Development of urethral stricture after transurethral prostatectomy: retrospective study. Int Urol Nephrol 24(1):49–53

    Article  PubMed  CAS  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Binhan Kagan Aktas.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Doluoglu, O.G., Gokkaya, C.S., Aktas, B.K. et al. Impact of asymptomatic prostatitis on re-operations due to urethral stricture or bladder neck contracture developed after TUR-P. Int Urol Nephrol 44, 1085–1090 (2012). https://doi.org/10.1007/s11255-012-0127-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11255-012-0127-y

Keywords

Navigation