Therapeutic Efficacy and Complication Profile of Monopolar Transurethral Resection of the Prostate (TURP) in the Management of Bladder Outlet Obstruction

Background: Bladder outlet obstruction (BOO) due to benign prostatic hyperplasia (BPH) is a common urological condition in aging men, often requiring surgical intervention for symptom relief. Objective: To evaluate the therapeutic efficacy and complication profile of monopolar transurethral resection of the prostate (TURP) in patients with BOO. Methodology: This descriptive observational study was conducted at the Department of Urology, Hayatabad Medical Complex, Peshawar, and Akhtar Saeed Trust Hospital, Lahore, from August 2022 to July 2024. A total of 518 male patients aged ≥ 50 years with BOO secondary to BPH underwent monopolar TURP. Preoperative, intraoperative, and postoperative variables were collected using a standardized proforma. Functional outcomes, including International Prostate Symptom Score (IPSS), maximum urinary flow rate (Qmax), and post-void residual volume (PVR), were assessed at baseline and one, six, and 12 months postoperatively. Complication rates and predictors were also analyzed. Results: Mean age was 68.42 ± 7.85 years. Significant improvement was observed in IPSS (from 23.74 ± 4.96 to 7.82 ± 2.81), Qmax (from 7.89 ± 2.11 mL/sec to 17.50 ± 4.67 mL/sec), and PVR (from 126.40 ± 34.70 mL to 30.10 ± 16.87 mL) at 12 months (p < 0.001). Early complications included hematuria in 42 patients (8.11%), UTI in 61 (11.78%), and TUR syndrome in six (1.16%). Late complications included urethral stricture (3.67%) and bladder neck contracture (2.12%). Conclusion: Monopolar TURP is an effective and safe surgical option for managing BOO due to BPH in resource-limited settings.