Relationship between development of urethral stricture after transurethral resection of prostate and glycemic control

Abstract

Objectives:The purpose of this study is to investigate the association of glycemic control prior to TUR-P and postoperative urethral stricture development.Materials and Methods:Of the 168 patients with a diagnosis of urethral stricture, who underwent internal urethrotomy in our hospital were retrospectively analyzed for this study.98 patients who underwent monopolar TUR-P in our hospital previously and were developed urethral stricture were divided into two groups as diabetic and nondiabetic. Based on their HbA1c concentrations, diabetics were allocated to two groups with good (HbA1c ≤6.5%) or poor (HbA1c > 6,5%) glycemic control. Time to internal urethrotomy and the other operative parameters were compared among groups.Results:Time to internal urethrotomy after TUR-P was significantly shorter in diabetic patients with poor glycemic control than Group 1 and Group 2 (P = 0,02, P = 0,012) but no significant difference was found between Group 1 and Group 2 (P = 0,368). There was no significant difference in the mean diagnosed and resected prostate wight among groups There was no significant difference in the mean resection time and the mean time to urethral catheter removal among groups.Conclusions:Especially in poor glycemic control patients, urethral stricture development was seen in the early period after TUR-P. For this reason, in the elective TUR-P scheduled poor glycemic controlled patients the operation should be done after glycemic control.

Risk Factors for Early Urethral Stricture After Mono-Polar Transurethral Prostate Resection: A Single-Center Experience

“…Diabetes mellitus (DM) is the most well-known comorbidity associated with urethral stricture occurring after TURP [ 8 - 9 ]. Similarly, Grechenkov et al noted that the presence of DM is an important risk factor for urethral stricture [ 8 ] and Kumsar et al reported that poor glycemic control increases the risk of developing urethral stricture in the early postoperative period [ 9 ].…”

“…Diabetes mellitus (DM) is the most well-known comorbidity associated with urethral stricture occurring after TURP [ 8 - 9 ]. Similarly, Grechenkov et al noted that the presence of DM is an important risk factor for urethral stricture [ 8 ] and Kumsar et al reported that poor glycemic control increases the risk of developing urethral stricture in the early postoperative period [ 9 ]. In contrast, our study included patients with other common comorbidities (asthma, COPD, CAD, hypertension) that could cause tissue ischemia and blood supply disorders and indicated that the risk of early urethral stricture after TURP increased as the comorbidity burden of the patient increased.…”

“…Although the etiology of urethral stricture after endoscopic urethral surgeries remains unclear, patientrelated factors, iatrogenic traumas developing during the surgery, and infections are the most frequently implicated factors. In addition, there are limited data in the literature suggesting that prolongation of the time spent in the urethra during surgery may impair urethral blood flow and cause ureteral epithelial disorders [7][8][9]. The aim of this study was to evaluate patients who underwent TURP and to investigate the demographic and clinical factors affecting the development of urethral stricture.…”

Relationship between the Severity of Coronary Artery Disease and Catheter-Associated Urethral Stricture in Patients with Acute Coronary Syndrome

“…Urethral stricture due to urethral ischemia and diabetes may be closely related as a result of endothelial dysfunction, which affects different vascular beds of various diameters and, as a result, gives rise to the development of systemic atherosclerosis. 24 , 25 Further, in a study conducted by Kumsar et al, 26 increased HbA1c levels were found to be associated with urethral stricture development after the transurethral resection of the prostate. Although troponin was also found to be statistically significant for urethral stricture prediction when evaluated in the multivariate analysis, odds ratios showed that troponin was not clinically significant.…”

Author reply on: Relationship between development of urethral stricture after transurethral resection of prostate and glycemic control

“…We have read the original article titled “relationship between development of urethral stricture after transurethral resection of the prostate and glycemic control.” by Kumsar et al . [ 1 ] with great interest.…”