Photo Credit: Eugene Nekrasov

The following is a summary of “Urethral-sparing laparoscopic simple prostatectomy for the treatment of benign prostatic hyperplasia with asymptomatic urethral stricture after urethral stricture surgery,” published in the April 2024 issue of Urology by Hou et al.

In this retrospective analysis, the researchers investigated the efficacy of urethral-sparing laparoscopic simple prostatectomy (US-LSP) as a treatment modality for large-volume benign prostatic hyperplasia (BPH) accompanied by asymptomatic urethral stricture following previous urethral stricture surgery. From January 2016 to October 2021, the study group assessed the clinical outcomes of 39 BPH patients with asymptomatic urethral strictures who underwent US-LSP. 

All of these patients experienced significant BPH-related lower urinary tract symptoms (LUTS), including 22 cases with anterior urethral strictures and 17 with posterior urethral strictures. The median operative time was 118 minutes, with a median estimated blood loss of 224 ml. Postoperative complications were observed in 5 patients (12.8%), mainly categorized as Clavien-Dindo grade 1 and 2. During follow-up, US-LSP led to statistically significant improvements in LUTS compared to baseline (P < 0.05). Notably, US-LSP demonstrated a favorable impact on ejaculatory function, with retrograde ejaculation reported in only 12% of patients who previously had normal ejaculation preoperatively. 

Additionally, the procedure was associated with a low risk of stress urinary incontinence (SUI), with only 5.1% of patients reporting this complication postoperatively. Importantly, none of the patients experienced aggravated urethral stricture during the follow-up period. These findings suggest that US-LSP is a safe and effective treatment option for large-volume BPH with asymptomatic urethral stricture following previous urethral stricture surgery, offering favorable outcomes in terms of LUTS improvement, ejaculatory function preservation, and low incidence of SUI.

Source: bmcurol.biomedcentral.com/articles/10.1186/s12894-024-01487-8