Impact of Surgical Duration on Morbidity after Monopolar Transurethral Resection of the Prostate: A Prospective Analysis

Surgical Duration after Monopolar Transurethral Resection of the Prostate

Authors

  • Babar Zaman Department of Urology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan
  • Faisal Haneef Department of Urology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan
  • Shuah Ullah Department of Urology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan
  • Asad Shehzad Department of Urology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan
  • Adib Ul Hassan Rizvi Department of Urology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v7i7.3740

Keywords:

Mono-Polar TURP, Surgical Complication, Transurethral Resection of Prostate, Resection Time Duration

Abstract

Benign prostatic hyperplasia (BPH) is associated with high morbidity and poses serious health problems in elderly males. The most effective surgical treatment for BPH that effectively relieves lower urinary tract symptoms is transurethral resection of the prostate (TURP). Still, TURP is not without complications, which can impact patient issues. Objective: To contribute to the existing knowledge on TURP complications with respect to resection time duration. Methods: From January 2021 to June 2022, this prospective cross-sectional study included 639 individuals with benign prostatic hyperplasia (BPH) and a prostate volume of 30 – 80 milliliters who underwent monopolar transurethral resection of the prostate (M-TURP) at Sindh Institute of Urology and Transplantation between the periods of 50 and 80. Complications were noted throughout a one- month follow-up period, and cases were grouped according to the length of surgery. The purpose of the study was to assess the results and benefits of M- TURP in BPH cases. Results:  In 639 cases undergoing monopolar TURP, postoperative complications were observed in 11.6 % of cases, with a significant association between complications and surgical duration (p=0.006). Sepsis was more common in longer procedures (p=0.025), followed by Incontinence (6%), hematuria (4.6%), and urinary tract infections (1.5%). Conclusions:  M-TURP is a dependable and effective treatment for enlarged prostate, with careful case selection and optimized surgical duration being pivotal to minimizing complications.

References

Chen X, Yang S, He Z, Chen Z, Tang X, Lin Y et al. Comprehensive Analysis of the Global, Regional, and National Burden of Benign Prostatic Hyperplasia from 1990 to 2021. Scientific Reports. 2025 Feb; 15(1): 5644. doi: 10.1038/s41598-025-90229-3. DOI: https://doi.org/10.1038/s41598-025-90229-3

Oelke M, Bachmann A, Descazeaud A, Emberton M, Gravas S, Michel MC et al. EAU Guidelines on the Treatment and Follow-Up of Non-Neurogenic Male Lower Urinary Tract Symptoms Including Benign Prostatic Obstruction. European Urology. 2013 Jul; 64(1): 118-40. doi: 10.1016/j.eururo.2013.03.004. DOI: https://doi.org/10.1016/j.eururo.2013.03.004

Te AE, Ramaswamy A, Kaplan SA. Medical Therapy for Benign Prostatic Hyperplasia and Lower Urinary Tract Symptoms. Urologic Clinics. 2025 Nov; 52(4): 595-604. doi: 10.1016/j.ucl.2025.08.001. DOI: https://doi.org/10.1016/j.ucl.2025.08.001

Porto JG, Bhatia AM, Bhat A, Suarez Arbelaez MC, Blachman-Braun R, Shah K et al. Evaluating Transurethral Resection of the Prostate Over Twenty Years: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. World Journal of Urology. 2024 Nov; 42(1): 639. doi: 10.1007/s00345-024-05332-3. DOI: https://doi.org/10.1007/s00345-024-05332-3

Gill BC, Miller LE, Bhattacharyya S, Cash H, Eure GR. Complications of Greenlight Laser vs Transurethral Resection of the Prostate for Treatment of Lower Urinary Tract Symptoms: Meta-Analysis of Randomized Trials. Urology. 2024 Feb; 184: 259-65. doi: 10.1016/j.urology.2023.12.018. DOI: https://doi.org/10.1016/j.urology.2023.12.018

Stucki P, Marini L, Mattei A, Xafis K, Boldini M, Danuser H. Bipolar versus Monopolar Transurethral Resection of the Prostate: A Prospective Randomized Trial Focusing on Bleeding Complications. The Journal of Urology. 2015 Apr; 193(4): 1371-6. doi: 10.1016/j.juro.2014.08.137. DOI: https://doi.org/10.1016/j.juro.2014.08.137

Tang Y, Li J, Pu C, Bai Y, Yuan H, Wei Q et al. Bipolar Transurethral Resection versus Monopolar Transurethral Resection for Benign Prostatic Hypertrophy: A Systematic Review and Meta-Analysis. Journal of Endourology. 2014 Sep; 28(9): 1107-14. doi: 10.1089/end.2014.0188. DOI: https://doi.org/10.1089/end.2014.0188

Cornu JN, Ahyai S, Bachmann A, de la Rosette J, Gilling P, Gratzke C et al. A Systematic Review and Meta-Analysis of Functional Outcomes and Complications Following Transurethral Procedures for Lower Urinary Tract Symptoms Resulting from Benign Prostatic Obstruction: An Update. European Urology. 2015 Jun; 67(6): 1066-96. doi: 10.1016/j.eururo.2014.06.017. DOI: https://doi.org/10.1016/j.eururo.2014.06.017

Lekei EE, Mbwambo JS, Bright F, Elias M, Cheyo ZI, Mteta AK et al. Short-Term Outcome and Predictors of Post-Operative Complications Following Transurethral Resection of the Prostate among Patients with Benign Prostate Hyperplasia in Northern Tanzania: A Prospective Analytical Study. African Journal of Urology. 2025 May; 31(1): 36. doi: 10.1186/s12301-025-00507-9. DOI: https://doi.org/10.1186/s12301-025-00507-9

Patankar SB, Narkhede MM, Padasalagi G, Thakare K. Prospective Randomized Study Correlating Intra-Operative Urethral Mucosal Injury with Early Period After Transurethral Resection of the Prostate Stricture Urethra: A Novel Concept. Asian Journal of Urology. 2024 Jul; 11(3): 466-72. doi: 10.1016/j.ajur.2024.02.006. DOI: https://doi.org/10.1016/j.ajur.2024.02.006

Khalil MA, Abbasi S, Nawaz R, Rashid NU, Ghazi MA, Patujo YH et al. Therapeutic Efficacy and Complication Profile of Monopolar Transurethral Resection of the Prostate (TURP) in the Management of Bladder Outlet Obstruction. Cureus. 2025 Aug; 17(8). doi: 10.7759/cureus.89640. DOI: https://doi.org/10.7759/cureus.89640

Akpala A, Warda A, Batson-Patel S, Bhattacharyya S, Damola A, Farag A et al. Comparing Urethral Stricture Rates Following Bipolar and Monopolar Transurethral Resection of the Prostate: A Retrospective Study. Cureus. 2024 Nov; 16(11). doi: 10.7759/cureus.73548. DOI: https://doi.org/10.7759/cureus.73548

Choi SY, Kim TH, Myung SC, Moon YT, Do Kim K, Kim YS et al. Impact of Changing Trends in Medical Therapy on Surgery for Benign Prostatic Hyperplasia Over Two Decades. Korean Journal of Urology. 2012 Jan; 53(1): 23. doi: 10.4111/kju.2012.53.1.23. DOI: https://doi.org/10.4111/kju.2012.53.1.23

Khan M, Khan AL, Khan S, Nawaz H. Benign Prostatic Hyperplasia: Mode of Presentation and Postoperative Outcome. The Journal of the Pakistan Medical Association. 2005 Jan; 55(1): 20-3.

Morton A, Williams M, Perera M, Teloken PE, Donato P, Ranasinghe S et al. Management of Benign Prostatic Hyperplasia in the 21st Century: Temporal Trends in Australian Population‐Based Data. British Journal of Urology International. 2020 Sep; 126: 18-26. doi: 10.1111/bju.15098. DOI: https://doi.org/10.1111/bju.15098

Chen JS, Chang CH, Yang WH, Kao YH. Acute Urinary Retention Increases the Risk of Complications After Transurethral Resection of the Prostate: A Population‐Based Study. British Journal of Urology International. 2012 Dec; 110(11c): E896-901. doi: 10.1111/j.1464-410X.2012.11471.x. DOI: https://doi.org/10.1111/j.1464-410X.2012.11471.x

Vivien A, Lazard T, Rauss A, Laisné MJ, Bonnet F. Infection After Transurethral Resection of the Prostate: Variation among Centers and Correlation with a Long-Lasting Surgical Procedure. European Urology. 1998 Apr; 33(4): 365-9. doi: 10.1159/000019617. DOI: https://doi.org/10.1159/000019617

Geremew LM, Gelaw SA, Beyene AD. Assessing the Complications of Monopolar Transurethral Resection of the Prostate (M-TURP) Using Clavien-Dindo Complications Grading System. Ethiopian Journal of Health Sciences. 2022 May; 32(3). doi: 10.4314/ejhs.v32i3.17. DOI: https://doi.org/10.4314/ejhs.v32i3.17

Mbaeri TU, Abiahu JA, Obiesie EA, Odo C, Oranusi KC, Nwofor AM et al. Assessment of Complications of Transurethral Resection of the Prostate Using Clavien-Dindo Classification in South-Eastern Nigeria. Nigerian Journal of Surgery. 2020 Jul; 26(2): 142-6. doi: 10.4103/njs.NJS_20_20. DOI: https://doi.org/10.4103/njs.NJS_20_20

Souiden L, Tu LM, Bordeleau M, Laberge G, Richard PO, Ismail S. Prevalence and Predictive Factors of Complicated Urinary Tract Infections Post Bladder and Prostate Transurethral Resections. World Journal of Urology. 2025 Jun; 43(1): 398. doi: 10.1007/s00345-025-05775-2. DOI: https://doi.org/10.1007/s00345-025-05775-2

Downloads

Published

2026-07-31
CITATION
DOI: 10.54393/pjhs.v7i7.3740
Published: 2026-07-31

How to Cite

Zaman, B., Haneef, F., Ullah, S., Shehzad, A., & Rizvi, A. U. H. (2026). Impact of Surgical Duration on Morbidity after Monopolar Transurethral Resection of the Prostate: A Prospective Analysis: Surgical Duration after Monopolar Transurethral Resection of the Prostate. Pakistan Journal of Health Sciences, 7(7), 57–61. https://doi.org/10.54393/pjhs.v7i7.3740

Issue

Section

Original Article

Plaudit