Abstract
OBJECTIVE: This study aimed to evaluate the therapeutic effect of transurethral resection of the prostate (TURP) combined with transurethral incision of the bladder neck (TUIBN) compared to traditional TURP in treating benign prostatic hyperplasia (BPH), with a focus on minimizing bladder neck contracture. METHODS: This was a retrospective study analyzing data from 112 patients with small-volume BPH treated between December 2015 and May 2020, who were divided into a TURP group (control, N = 56) and a TURP + TUIBN group (observation, N = 56). The safety and effectiveness of the combined technique were assessed through perioperative complications, clinical symptoms (IPSS, QOL), urodynamics (Qmax, PVR, PV), and incidence of bladder neck contracture. RESULTS: No significant difference was found in perioperative complications (P > 0.05). While IPSS and QOL scores were similar at 3 months (P > 0.05), the TURP + TUIBN group exhibited better urodynamic outcomes (Qmax, PVR; P < 0.05) and a significantly lower incidence of bladder neck contracture at 12 months (3.6% vs. 14.3%; P = 0.04). The observation group showed greater improvement in IPSS (from 22.1 ± 3.5 to 4.5 ± 0.5 vs. control: 22.3 ± 3.2 to 6.8 ± 1.2; P < 0.01) and Qmax (from 7.3 ± 2.1 to 19.6 ± 3.5 mL/s vs. control: 7.5 ± 1.9 to 17.8 ± 1.4 mL/s; P < 0.05). At 3-month follow-up, urodynamic improvements remained significant in the observation group (P < 0.05). Bladder neck contracture incidence was significantly lower in the observation group. CONCLUSION: Within the study's limits, TURP + TUIBN is a viable alternative to TURP alone for small-volume BPH, particularly effective in reducing bladder neck contracture, with additional improvements in functional outcomes. Further studies are warranted to confirm these findings.