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Modified transurethral resection of the prostate for the management of BPH-related refractory lower urinary tract symptoms in patients with a history of pelvic fracture urethral injury reconstruction

  • Urology - Original Paper
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Abstract

Introduction

To evaluate the impact of a modified transurethral resection of prostate (mTURP) in patients with a history of pelvic fracture urethral injury (PFUI) status post-urethroplasty, and subsequent lower urinary tract symptoms (LUTS) refractory to medical therapy caused by benign prostatic hyperplasia (BPH).

Methods

Five patients were identified with a history of PFUI and a successful reconstruction of the urethra, who developed severe LUTS. After maximal medical therapy failed, these patients underwent a mTURP. Their continence status and voiding parameters were recorded before and after surgery.

Results

Significant improvements in both post-void residual (172 ± 137.36 mL vs. 26.6 ± 24.44 mL), p = 0.026, and International Prostatic Symptom Score (23.6 ± 4.82 vs. 7.6 ± 4.30), p = 0.002 were observed in the study. Although maximum flow rate was not statistically significant, there was an overall improvement in Qmax in all patients (8.92 ± 3.71 vs. 16.78 ± 6.44 mL/sec). Furthermore, all patients remained continent after this modified intervention.

Conclusion

Our modified TURP provides an adjunctive option in the management of severe LUTS secondary to BPH in patients with a history of PFUI urethroplasty who are refractory to medical management. In our experience, the patients experienced a lasting response with no incontinence.

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Abbreviations

PFUI:

Pelvic fracture urethral injury

BPH:

Benign prostatic hyperplasia

mTURP:

Modified transurethral resection of prostate

LUTS:

Lower urinary tract symptoms

PVR:

Post-void residual

IPSS:

International Prostate Symptom Score

TRUS:

Transrectal ultrasound

IPP:

Intravesical prostatic protrusion

TURP:

Transurethral resection of prostate

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Authors and Affiliations

  1. Urology Institute, University Hospitals, Cleveland Medical Center, Cleveland, OH, USA

    Kirtishri Mishra & Laura Bukavina

  2. Case Western Reserve University School of Medicine, Cleveland, OH, USA

    Kirtishri Mishra & Laura Bukavina

  3. Urology Service, Hospital del Trabajador, Ramón Carnicer 185, Providencia, Santiago, Región Metropolitana Chile, Chile

    Cristina Baeza & Reynaldo G. Gómez

  4. Universidad Andres Bello School of Medicine, Santiago, Chile

    Cristina Baeza & Reynaldo G. Gómez

Authors
  1. Kirtishri Mishra
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  2. Cristina Baeza
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  3. Laura Bukavina
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  4. Reynaldo G. Gómez
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Contributions

Mishra: data analysis, manuscript writing/editing, Cristina Baeza: data analysis, protocol/project management, Laura Bukavina: data analysis, manuscript writing/editing, Reynaldo G. Gómez: protocol/project management, data analysis, manuscript writing/editing.

Corresponding author

Correspondence to Reynaldo G. Gómez.

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All authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Cite this article

Mishra, K., Baeza, C., Bukavina, L. et al. Modified transurethral resection of the prostate for the management of BPH-related refractory lower urinary tract symptoms in patients with a history of pelvic fracture urethral injury reconstruction. Int Urol Nephrol 51, 2137–2141 (2019). https://doi.org/10.1007/s11255-019-02276-1

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  • DOI: https://doi.org/10.1007/s11255-019-02276-1

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