Comparing the incidence of Bladder Neck Stenosis post monopolar Transurethral Resection of the Prostate; small prostates versus larger prostates in the black African population

Abstract

Monopolar Transurethral Resection of the Prostate (TURP) is the commonly done procedure for surgical removal of the prostate after open prostatectomy in our subregion. It is still a novel procedure in our subregion, as very few centers offer this procedure. It is generally believed that the size of the prostate may influence the development of complications of bladder neck stenosis. This is a dreaded complication, which requires further surgical procedure to correct in a resource-poor environment. We decided to compare the incidence of Bladder Neck Stenosis (BNS) in small vs larger prostates following monopolar TURP in our black African subregion. We prospectively studied 194 patients who underwent TURP in our facility from 2015 to 2022 that satisfied the inclusion criteria. Eighty-five participants (43.81%) had a small prostate (Transrectal Ultrasound, TRUS, weight <30 g), and 109 participants (56.19%) had a large prostate (TRUS weight >30 g). Overall, ten participants (5.15%) had postoperative BNS. Participants with smaller prostates had more incidence of bladder neck contracture than those with larger prostates, although this did not reach statistical significance, Fisher’s Exact test p=0.338. Multifactorial reasons and not prostate size alone may be responsible for BNS. There may be a need for larger-scale standardized studies on prostate size effect on BNS.