Abstract
INTRODUCTION AND AIM: Benign prostatic hyperplasia (BPH) is a prevalent condition in aging males, often leading to lower urinary tract symptoms (LUTS). While transurethral resection of the prostate (TURP) is the gold standard for surgical management, transurethral incision of the prostate (TUIP) is a less invasive alternative for small prostate volumes. This study aims to compare the efficacy and safety of TURP and TUIP in patients with small prostate glands (<30 mL) suffering from BPH. METHODS: A prospective cohort study was conducted from August 2024 to January 2025 on 70 patients divided into two groups: Group I (TURP, n = 35) and Group II (TUIP, n = 35) at the Urology Department of Sindh Institute of Urology and Transplantation, Karachi. Preoperative and postoperative parameters, including International Prostate Symptom Score (IPSS), urinary flow rates, voided volume, post-void residual (PVR), operative time, catheterization duration, and hospital stay, were analyzed. Statistical analysis was performed using IBM SPSS Statistics for Windows version 25. RESULTS: Both groups showed significant improvements in IPSS, average flow rate, maximum flow rate, and PVR at six-month follow-up. TURP had a longer operative time (mean: 61.2 min) compared to TUIP (mean: 32.4 min, p < 0.001). Catheterization duration and hospital stay were shorter in the TUIP group (p < 0.05). Blood transfusion was required in 5.7% of TURP patients and none in the TUIP group. Retrograde ejaculation was more common in the TURP group, 40% versus 12% in the TUIP group. No significant difference was noted in reoperation rates. CONCLUSION: TUIP is a safe and effective alternative to TURP for small-sized prostates, offering comparable symptomatic relief with shorter operative times, reduced catheterization duration, and fewer complications.