Readmission and Reoperation Following Transurethral Incision of the Prostate for Benign Prostatic Obstruction: A 20-Year Retrospective Review and Analysis

Introduction: Transurethral Incision of the Prostate (TUIP) is a recognized surgical treatment for benign prostatic obstruction (BPO), particularly in patients with smaller glands. While valued for its minimal invasiveness, it is associated with higher medium-term reoperation rates. This study analyzes a 20-year institutional experience to define the rate, timing, causes, and predictors of readmission and reoperation after TUIP. Methods: A retrospective review of 557 patients who underwent TUIP for BPO was conducted. Data collected included demographics, comorbidities, perioperative details and complications graded by the Clavien-Dindo system. Univariate and multivariate logistic regression analyses identified predictors of readmission and reoperation if present. Results: The overall reoperation rate was 12.9% (72/557). Strikingly, no readmissions (days) occurred for typical perioperative issues like hemorrhage or infection. All rehospitalization were late (>90 days) and attributable to recurrent bladder outlet obstruction (BOO) from regrown adenoma (58.3%), urethral stricture (25.0%), or bladder neck contracture (16.7%). The procedure demonstrated an excellent safety profile with low major complication (0.7%) and no transfusion rates. Multivariate analysis identified older age (OR 1.08 per year, p