Impact of COVID-19-related prolonged catheterization on bipolar TURP outcomes

Abstract

Aim: To evaluate the early and long-term clinical outcomes of bipolar transurethral resection of the prostate (B-TURP) surgery in patients with prolonged preoperative urethral catheterization due to their operations being postponed during the COVID-19 pandemic.

Materials and Methods: Patients with benign prostatic hyperplasia (BPH) whose B-TURP procedures were delayed due to the COVID-19 pandemic were analyzed. The patients were divided into two groups: Patients awaiting surgery without a catheter were defined as Group A, while those who developed acute urinary retention (AUR) and were catheterized were defined as Group B. Preoperative and postoperative International Prostate Symptom Score (IPSS) values, IPSS subscores (voiding and storage), early and long-term clinical outcomes, and complications were compared.

Group A included 53 patients who were operated on without a catheter, and Group B included 68 patients who waited for surgery with a catheter in place for an average of 89.6 days. No statistically significant differences were found between Group A and Group B in terms of age, body mass index, IPSS, American Society of Anesthesiologists score, length of hospital stay, or total follow-up duration (p > 0.05). However, Group B had significantly higher prostate-specific antigen levels, prostate volume, operative time, specimen weight, and perioperative catheterization time compared to Group A (p < 0.01). While total IPSS scores were similar between the groups, Group B exhibited significantly higher IPSS voiding scores, but significantly lower IPSS storage scores compared to Group A (p < 0.001). When assessing the IPSS voiding-to-storage (V/S) ratio, both the 12-month and long-term values were significantly higher in Group B than in Group A (p < 0.001).

Conclusion: Postponing the elective surgeries and the necessity of prolonged catheterization during the COVID-19 pandemic resulted in functional voiding impairments following B-TURP in patients who developed AUR due to BPH.