Urethral Stricture After Transurethral Resection of the Prostate/Bladder: a Prospective Study of Risk Factors
Urethral Stricture After Transurethral Resection of the Prostate/Bladder: a Prospective Study of Risk Factors
There is currently no prognostic or predictive risk marker for this urethral stricture
 disease.

 The most conservative standard treatment for urethral stricture (internal urethrotomy) has a
 very high recurrence rate (greater than 75%) and, on many occasions, reconstructive
 urologists have to choose within a great variety of further complex interventions. Knowing
 risk and predictive markers of this disease could help to optimize both the need and the
 approach for these surgeries and may offer a more individualized management to patients.
The pathophysiological mechanisms that influence the development of urethral stricture are
 not established. In developed countries, the most common etiology of urethral stricture is
 idiopathic (41%) followed by iatrogenic (35%).

 Serum testosterone is important in urethral development, in the integrity of the corpora
 cavernosa and has been shown to play a fundamental role in the development of genital
 structures. Recently, hypoandrogenism (HA) has been associated with a decrease in urethral
 androgen receptors and periurethral vascularization. Furthermore, low serum testosterone
 levels appear to be implicated in an increased risk of urethral atrophy.

 In recent years it has been proven that coagulation, in addition to influencing the formation
 of the provisional matrix, participates in mechanisms of tissue injury through the activation
 of PARs. As a result, the coagulation cascade directly influences several key aspects of the
 wound healing response, from platelet aggregation and vasoconstriction, but also inflammation
 and scar formation. Although it is strictly regulated under normal conditions, an imbalance
 in favor of a procoagulant state as occurs in many pathologies of other organs (liver, lung,
 kidney) has the potential to deregulate inflammatory and tissue repair mechanisms and
 culminate in fibrosis.

 In general, it is accepted that the probability of developing a urethral stricture after
 endoscopic treatment is around 2-10% of cases. However, this complication has never been
 studied in depth and the true incidence of urethral stricture, and its consequences in
 quality of life, after a transurethral procedure is unknown.

 The aim of this study is to analyze the potential role of serum hormonal status and
 coagulation disorders as risk factors for the development of urethral stricture after
 transurethral surgery.
Inclusion Criteria:

 -  Patients undergoing transurethral resection of the prostate or bladder (TUR P/B) at
 our department.

 Exclusion Criteria:

 -  Patients not giving their informed consent

 -  Patients with urethral catheter at the moment of TUR P/B

 -  Patients with any type of urethral stricture at the moment of TUR P/B

 -  Patients under hormonal treatments (testosterone, thyroxine...) 1 year before the TUR
 P/B.

 -  Patients with already known coagulation disorders or undergoing anticoagulation
 treatments at the moment of the blood test.