Anyone considering TURP should read this about strictures

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A friend who is an RN in the US just emailed a link to this abstract.  I've had horrible stricture problems that have messed me up in a way that may not be repairable.  I've wondered whether the latex catheter used played a role, as I later discovered I have a latex sensitivity.   This study suggests that a Foley after TURP is problematic.

Abstract is below, cut an pasted.

Urethral strictures following transurethral resection of the prostate. The role of the catheter.Randomized controlled trial

Hammarsten J, et al. Br J Urol. 1989.

Urethral stricture is the most common late complication of transurethral prostatectomy (TURP). The cause is unknown. A prospective, randomised study was undertaken to investigate the role of the transurethral catheter in stricture formation. A total of 205 patients subjected to TURP were studied. Following resection, they were randomly divided into 2 groups: those drained by a transurethral siliconised latex catheter and those drained by a suprapubic siliconised latex catheter. At follow-up, 6 to 24 months later, 17% of the patients in the transurethral group had developed urethral stricture; the corresponding figure in the suprapubic group was 4%. As a consequence of the higher incidence of stricture in the transurethrally drained group, more patients in that group were dissatisfied with the results of the operation. It was concluded that the post-operative transurethral catheter was an important factor in stricture formation following TURP and that transurethral drainage with a siliconised latex catheter resulted in a higher incidence of stricture. This led to a greater number of patients being dissatisfied with the results of the operation, but the catheter did not affect the results in any other way.

PMID 2713622 [PubMed - indexed for MEDLIN

 

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  • Posted

    I wonder if this applies to all transurethral procedures like HOLEP PVP etc. If just the catheter is causing stricture then wouldn't procedure like FLA produce stricture also

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    • Posted

      The data in the reference I found only was comparing the effects on a transurethral catheter to supra pubic catheter following TURP, etc.  One study compared stricture rates to the type of material used in the catheter tubing.  What was found was the longer the catheter was in place, the greater the chance of getting strictures.  The studies did not break down the stricture locations, but seemed to say a lot were anterior and even at the meatus.  Bladder neck strictures occured at a lower rate from the Foley catheters after TURP.

      I now know that I have a significant latex sensitivity.  I suspect that could have been a significant  factor in my long and posterior, close "right at the sphincter" in the words of my current urologist.  I believe that the posterior stricture as the direct cause of the incontinence that has drastically changed my life following March 10, 2016, the date of my GL procedure for BPH.  The first Foley came out after 24 hours, but inflammation led to a Saturday night acute retention event.  My doctor had gone out of town for a week or two, so the Foley remained in for nearly a week.  Two months later, the doctor did a second procedure, Gyrus TURP, to clean up a lot of hanging debris from the GL that still had the prostate inflammed.  After that procedure, the Foley was in for 5 or 6 days as I recall.

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