Incidence of Overactive Bladder Symptoms and Dysuria Following Transurethral Interventions for Benign Prostatic Enlargement: A Systematic Review and Meta‐Analysis of Comparative and Randomized Studies

Some patients report persistent/recurrent lower urinary tract symptoms (LUTS) after benign prostatic enlargement (BPE) surgery. This study aims to systematically assess the incidence of storage symptoms and dysuria after transurethral treatment of BPE in randomized studies comparing transurethral resection of the prostate (TURP) versus Enucleation versus Ablation procedures. This study adhered to the 2020 PRISMA framework. A broad literature search was performed in January 2025, using Embase, PUBMED, and Scopus using a combination of Medical Subject terms and keywords. Only English and randomized studies were accepted. Incidence of postoperative LUTS (storage symptoms and dysuria) was sorted in early (up to 3 months), and persistent (> 3 months) and assessed using the Cochran-Mantel-Haenszel Method with the random effect model and reported as odds ratio (OR), 95% confidence interval (CI), and p values. OR > 1 indicates that TURP decreases the odds of postoperative LUTS. A total of 35 studies were accepted (546 patients in Enucleation, 1678 in Ablation, and 1702 in TURP). Incidence of early postoperative LUTS favors the TURP group compared with Ablation (OR 1.72). Subanalysis demonstrates no difference between monopolar (M)-TURP and Ablation but LUTS favors bipolar (B)-TURP (OR 10.69). Early postoperative LUTS favors the TURP compared with Enucleation (OR 1.71). Persistent postoperative LUTS favors the TURP group compared with Ablation (OR 2.75). Early postoperative storage symptoms favor B-TURP over Ablation (OR 4.00) and Enucleation (OR 1.71). Late postoperative storage symptoms favor TURP over Ablation (OR 2.13). Early postoperative dysuria was similar between TURP versus Enucleation and versus Ablation. Persistent postoperative dysuria favors M-TURP compared with Ablation (OR 6.92). TURP is associated with a lower odds of early and persistent LUTS compared to Ablation and Enucleation and is a valuable option particularly when minimizing postoperative LUTS is a priority.