Does asymptomatic prostatic inflammation alter the outcome of transurethral resection of prostate?

Introduction: There is contradictory evidence in literature with respect to the association of asymptomatic prostatic inflammation on biopsy with complications of Transurethral Resection of Prostate. The aim of the present study was to evaluate the association of prostatitis in biopsy specimens of patients undergoing transurethral resection of prostate with bladder neck contracture (the primary end point) and other complications.

Material and methods: Patients who had undergone transurethral resection at a single centre between 2005 and 2010, with a minimum of 3 months follow-up were included. The study population was divided into two cohorts: those with inflammation on prostatic biopsy (Group A) and those without (Group B). These two groups were compared with respect to demographic data and pre-operative and intraoperative confounding factors. Immediate complications were documented using the modified Clavien-Dindo system and compared. Long term complications like bladder neck contracture, meatal stenosis, urethral stricture, and recurrent adenoma were also compared.

Results: Both groups were comparable except for Group A patients having a higher median resected weight (20 vs. 14 gms, p = 0.009). There was no significant difference between the groups with respect to the rate of bladder neck contracture and other long-term and short term complications on univariate and multivariate analysis. Larger resected weight of gland was associated with lower rate of bladder neck contracture on multivariate analysis (p = 0.019, Odds ratio: 0.937).

Conclusions: Presence of histologically confirmed prostatic inflammation is not associated with bladder neck contracture or other complications following transurethral resection. Smaller resected prostatic weight was associated with higher incidence of bladder neck contracture.