Urethral Stricture after Transurethral Resection of Prostate: Role of Maintaining the Temperature of the Urethra with Warm Irrigation Solution

Abstract

With popularization of transurethral resection of the prostate (TURP), currently, iatrogenic reason is the leading etiology of urethral stricture. Urethral stricture often occurs after TURP, and the triggering factors reported include infection, mechanical injury, and indwelling of the Foley catheter. However, the exact etiology of urethral stricture is still controversial. In our opinion, the temperature in the urethra could be another important factor in stricture formation after TURP. When the body temperature decreases by 1-2°C below the normal temperature, the blood vessels constrict, lessening heat loss to the outside environment. The constriction of blood vessels in the urethra during TURP can also induce ischemic injury in the urethra, resulting in urethral stricture. Warm irrigation and a system to maintain the penis at isothermia during TURP might decrease the incidence of urethral stricture and morbidity. The results of our previous study, entitled “Is warm temperature necessary to prevent urethral stricture in combined transurethral resection and vaporization of prostate?” have shown that maintaining the temperature of the urethra with warm irrigation solution during combined transurethral resection and vaporization of the prostate probably decreases the incidence of urethral stricture. We recommended warm irrigation and a system to maintain the penis at isothermia during TURP to prevent ureteral stricture.