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Surgery

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Genito-Urinary System

Question
80 out of 130
 

Most common site of stricture following long lasting TURP?

A Bladder neck
B Navicular fossa
C Mid bulb
D Prostatomembranous region
Ans. B Navicular fossa > C Mid bulb.
  1. Urethral strictures are the most common late complication of transurethral prostate surgery.
  2. They should be considered in any patient who underwent TURP who has symptoms of outlet obstruction or a peak flow rate of 10 mL/s or less.
  3. Most post-TURP urethral strictures are found at the fossa navicularis and the bulbous urethra.
  4. No difference in urethral stricture formation rate was noted when suprapubic tubes were used instead of Foley catheters post-TURP. Coaxial continuous-flow resectoscopes tend to create fewer urethral strictures, most likely because they require less intermittent handling for bladder emptying.

Surgical complications: diagnosis and treatment by Nadey S. Hakim, - Page 600:

Urethral stricture occurs in up to 5%156 of patients post-TURP, most commonly in the membranous, bulbopenile junction and fossa navicularis regions of the urethra secondary to trauma from the resectoscope.

Complications of urologic surgery: prevention and management by Samir S. Taneja, Robert B. Smith, Richard Michael Ehrlich - 2001 – pg. 637:

Urethral stricture, bladder neck contracture, inadequate tissue resection, and atonic bladder dysfunction all need to be remembered as poteintial complications of urologic prostatic surgeries. The membranous urethra, penoscrotal junction, and fossa navicularis are the most common sites for such strictures.

Principles & practice of urology: a comprehensive text by Muhammad Abdus Salam: Volume 2 - Page 860:

Stricture most often occurs at the fossa navicularis following TURP. Stricture may happens in the bladder neck too. Common site of post TURP Stricture include:

  1. Fossa navicularis
  2. Bladder neck
  3. Sub-sphincleric area
  4. Retrograde ejaculation results from the destruction of the bladder neck during TURP. During normal ejaculation, the bladder neck closes under sympathomimetic influence, allowing the semen to flow forward. The bladder neck is unable to close after TURP, permitting semen to flow backwards into the bladder. This is a very common sequela after TURP.

Genito-Urinary System Flashcard List

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