Which of the following is the most common cause of delayed UT obstructive symptom after TURP
**Core Concept:** Transurethral Resection of Prostate (TURP) is a surgical procedure commonly used to treat benign prostatic hyperplasia (BPH), which is the most common cause of prostate enlargement in older men. BPH leads to obstruction of the urinary tract, resulting in obstructive urinary symptoms like lower urinary tract symptoms (LUTS). Post-TURP complications include acute urinary retention (AUR), delayed UT obstruction, and bladder neck contracture.
**Why the Correct Answer is Right:** Delayed UT obstruction is the most common complication after TURP due to incomplete removal of the prostate tissue, leading to inadequate decompression of the bladder neck and urethra. This results in a narrowed urethral lumen, causing obstruction and subsequent obstructive urinary symptoms.
**Why Each Wrong Option is Incorrect:**
A. Acute urinary retention (AUR) is a more immediate complication of TURP, usually occurring within 24-48 hours after surgery, rather than delayed.
B. Post-TURP bleeding is a separate complication unrelated to urethral obstruction.
C. While bladder neck contracture may occur after TURP, it is not the most common cause of delayed UT obstruction following TURP.
D. Post-TURP incontinence is another potential complication, but it is not directly related to urethral obstruction.
**Clinical Pearl:** In clinical practice, it is essential to recognize and manage delayed UT obstruction post-TURP promptly to prevent complications like acute urinary retention, urinary tract infections, and renal impairment. A thorough evaluation of the patient's symptoms, along with a detailed history and physical examination, can help identify this complication. If necessary, further imaging studies like ultrasonography or cystoscopy may be required to confirm the diagnosis and guide management.