Bladder Neck Stenosis After Transurethral Prostate Surgery: a Systematic Review and Meta-analysis

Overview

Journal World J Urol

Specialty Urology

Date 2021 May 11

PMID 33974100

Citations 7

Authors

Daniele Castellani

Marcelo Langer Wroclawski

Giacomo Maria Pirola

Vineet Gauhar

Emanuele Rubilotta

Vinson Wai-Shun Chan

Bryan Kwun-Chung Cheng

Marilena Gubbiotti

Andrea Benedetto Galosi

Thomas R W Herrmann

Jeremy Yuen-Chun Teoh

Affiliations

Soon will be listed here.

Abstract

Purpose: Bladder neck stenosis (BNS) is a long-term complication of surgical procedures for benign prostatic hyperplasia (BPH). We performed a systematic literature review and a meta-analysis of the incidence of BNS after transurethral procedures for BPH.

Methods: We performed a systemic literature review using MEDLINE, EMBASE, and Cochrane Central Controlled Register of Trials. We accepted only randomized trials comparing transurethral resection of the prostate (TURP) vs. other transurethral surgery for BPH that were grouped in Ablation vs. Enucleation modalities. The incidences of BNS were pooled using the Cochran-Mantel-Haenszel Method with the random effect model and expressed as Risk Ratios, 95% Confidence Intervals, and p values. Study heterogeneity was assessed utilizing the I value.

Results: 72 studies were identified for meta-analysis, 46 comparing TURP vs. Ablation and 26 TURP vs. Enucleation. The pooled incidence of BNS was 1.3% after TURP, 0.66% after enucleation and 1.2% after Ablation. The incidence of BNS was higher after TURP than after Enucleation but the difference was not statistically significant (RR 1.75 95% CI 0.81-3.79, p = 0.16). There was no significant heterogeneity among the studies (I 0%, Chi 4.11, p = 0.90). The incidence of BNS was higher after TURP than after Ablation, but the difference was not statistically significant (RR 1.31, 95% CI 0.82-2.11, p = 0.26) with no significant heterogeneity (I 0%, Chi 21.1, p = 0.51).

Conclusion: Our study showed no difference in the rate of BNS incidence among randomized trials comparing TURP vs. Ablation vs. Enucleation and can be used as a reference to counsel patients undergoing BPH surgery.

Citing Articles

Transurethral resection of the prostate across continents: a meta-analysis evaluating quality of gold standard in the twenty-first century.

Porto J, Bhatia A, Bhat A, Suarez Arbelaez M, Blachman-Braun R, Shah K World J Urol. 2025; 43(1):85.

PMID: 39856398 PMC: 11761131. DOI: 10.1007/s00345-024-05439-7.

Evaluating transurethral resection of the prostate over twenty years: a systematic review and meta-analysis of randomized clinical trials.

Porto J, Bhatia A, Bhat A, Suarez Arbelaez M, Blachman-Braun R, Shah K World J Urol. 2024; 42(1):639.

PMID: 39547977 PMC: 11568034. DOI: 10.1007/s00345-024-05332-3.

One-Year Outcomes of Transurethral Treatment of Bladder Neck Stenosis Following Transurethral Resection of the Prostate. Results from a Large, Multicenter Series.

Castellani D, Stramucci S, Enganti B, Lane J, Kumar S, Tanidir Y Int J Gen Med. 2024; 17:1967-1974.

PMID: 38736663 PMC: 11088407. DOI: 10.2147/IJGM.S459441.

Influence of Prostate Volume on the Incidence of Complications and Urinary Incontinence Following Thulium Fiber Laser Enucleation of the Prostate: Results from Multicenter, Real-world Experience of 2732 patients.

Castellani D, Enikeev D, Gokce M, Petov V, Gadzhiev N, Mahajan A Eur Urol Open Sci. 2024; 63:38-43.

PMID: 38558764 PMC: 10981004. DOI: 10.1016/j.euros.2024.03.004.

Incidence of complications and urinary incontinence following endoscopic enucleation of the prostate in men with a prostate volume of 80 ml and above: results from a multicenter, real-world experience of 2512 patients.

Gauhar V, Castellani D, Herrmann T, Gokce M, Fong K, Gadzhiev N World J Urol. 2024; 42(1):180.

PMID: 38507108 PMC: 10954849. DOI: 10.1007/s00345-024-04886-6.

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