Perioperative outcomes and prevalence of urethral strictures during surgery for benign prostatic hyperplasia: results from the GRAND study.

BACKGROUND: Limited data exist on the prevalence of urethral strictures during surgery for benign prostatic hyperplasia (BPH). We aimed to analyze their perioperative outcomes and trends. MATERIALS AND METHODS: The German Nationwide Inpatient Data (GRAND) registry was used to identify male patients diagnosed with urethral stricture who underwent surgery for BPH between 2005 and 2022. RESULTS: A total of 1,367,065 BPH surgeries were performed in Germany. Of them, 179,272 had a relevant concomitant urethral stricture (13%). Their median age was 72 years (interquartile range: 66-78). Patients with urethral stricture during BPH surgery underwent an internal urethrotomy in 155,482 (86%) cases, a dilatation of the urethral stricture in 14,162 (9%) cases, or a meatoplasty in 9,628 (5%) cases. The annual prevalence of relevant urethral strictures during BPH surgery has decreased from 14,872 cases in 2005 to 7,184 in 2022. Compared to patients with no urethral stricture, those with urethral strictures during BPH surgery displayed higher rates of postoperative incontinence (3.8% versus 3.7%, p<0.001) and reoperations (1.0% versus 0.8%, p<0.001). On the contrary, they were associated with lower rates of perioperative acute urinary retention (7.8% versus 10%, p<0.001). CONCLUSION: Urethral strictures during surgery for BPH display a high prevalence and may slightly affect perioperative outcomes.