Lower Urinary Tract Symptoms Following Transurethral Resection of Prostate.

PURPOSE OF REVIEW: Transurethral resection of the prostate (TURP) is the standard surgical therapy for lower urinary tract symptoms (LUTS) due to prostatic enlargement. Following TURP, LUTS may persist in a proportion of patients. Persistent LUTS necessitates proper evaluation and management. In this review, we sought to describe the prevalence, pathophysiology, and predictors of LUTS following TURP, as well as the recommended evaluation and management.

RECENT FINDINGS: Among the different techniques utilized for TURP, the prevalence of postoperative LUTS is similar. The chronically obstructed bladder has been shown to vary in its expression of collagen, tissue factors, and receptors when compared to the normal bladder which could contribute to the pathophysiology of LUTS after TURP. Although androgen receptors exist in the urinary epithelium, the role of sex hormones in LUTS remains obscure. GreenLight laser can lead to postoperative irritative voiding symptoms as a result of tissue necrosis. A large proportion of patients have persistent LUTS following TURP, with similar incidences between different techniques that can be used to perform TURP. LUTS after TURP should be evaluated with a thorough history and physical, including International Prostate Symptom Score, and urine culture to rule out infection. Noninvasive uroflow, post-void residuals, and subsequent urodynamic study or cystoscopy can be utilized as needed. Further research is necessary to be able to more precisely predict the patients who will experience no improvement in or worsening of LUTS following TURP.