Influence of urethral mucosa preservation of prostatic apex during monopolar transurethral resection of the prostate on postoperative functional outcomes: A retrospective comparative study

Purpose: The aim of this study is to compare the efficacy and functional outcomes of monopolar transurethral resection of the prostate (m-TURP) without and with the preservation of urethral mucosa at the prostatic apex. Materials and methods: In a retrospective study from June 2018 to June 2020, 53 patients with benign prostatic hyperplasia who undertook m-TURP were included in the study. The patients who underwent conventional m-TURP were considered group A (n = 26) and those who were operated by m-TURP with preserved prostate apex were considered group B (n = 27). Preoperative and operative parameters, postoperative complications, urinary incontinence (UI), postoperative 6-month functional outcomes including International Prostate Symptom Score, International Index of Erectile Function score, and peak flow rates (Q max) were assessed and compared between groups. Results: All preoperative parameters were similar in both groups without significant differences (P > 0.05). In group A, the mean operative time was significantly longer (40.59 ± 5.20 versus 33.84 ± 4.44 minutes), and intraoperative blood loss was significantly more (305 ± 63.4 versus 212.5 ± 65 mL) than in group B and both were statistically significant (P < 0.001 and P < 0.0001, respectively). Group B had significantly lower urge UI compared with group A (0% versus 23%; P = 0.008). Six-month follow-up data showed that the International Prostate Symptom Score, International Index of Erectile Function score, and Q max were improved in both groups with no statistically significant differences between the 2 groups (P > 0.05). Conclusion: Our results indicate that preservation of urethral mucosa at the prostatic apex can be associated with a lower incidence of early postoperative urge UI, less operative blood loss, and shorter operative length, thus improving surgical efficiency.