{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T17:19:52Z","timestamp":1785777592590,"version":"3.56.0"},"reference-count":9,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Dokuz Eyl\u00fcl University"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World J Urol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Urethral stricture (US) is a significant long-term complication of transurethral resection of the prostate (TURP), often linked to mechanical trauma during instrument insertion. This study evaluated whether advancing the resectoscope sheath under direct vision using a visual obturator reduces postoperative US incidence compared to blind insertion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>A retrospective multicenter study was conducted across four centers involving patients who underwent bipolar TURP between 2020 and 2025. After applying propensity score matching to minimize baseline bias, 962 patients were analyzed (481 per group: visual vs. blind obturator). Primary outcomes included US incidence, perioperative variables, and functional results (Qmax). Subgroup analysis was performed based on prostate volume.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The overall US incidence was 12.4%. Patients in the visual obturator group had a significantly lower US rate compared to the blind group (7.7% vs. 17.0%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Visual guidance also correlated with a significant reduction in overall postoperative complications and acute urinary retention. Subgroup analysis revealed that the protective effect of the visual obturator was most pronounced in prostates\u2009&gt;\u200960\u00a0cc. While traditional predictors like operative time and prostate volume showed modest discriminatory ability for US risk in the blind group, their impact was mitigated in the visual group. Both groups showed improved Qmax, with a higher baseline and more stable trend in the visual cohort.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Direct vision advancement of the resectoscope sheath using a visual obturator significantly reduces the risk of urethral stricture and postoperative morbidity. This technique offers a simple, effective strategy to minimize urethral trauma, particularly in larger prostates, and should be considered for routine use.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00345-026-06558-z","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T11:20:20Z","timestamp":1782213620000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Can the use of a visual obturator-assisted resectoscope reduce the incidence of urethral strictures after TURP?: a multicenter propensity-matched study"],"prefix":"10.1007","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5238-2691","authenticated-orcid":false,"given":"Muhammed Selcuk","family":"Ozer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Volkan","family":"Sen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alper Ege","family":"Sarikaya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmed Emin","family":"Kayacan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Murat","family":"Gulsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Murat","family":"Isitan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nebil","family":"Akdogan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laith Abedalqader Abdul Hadi","family":"Albanna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cemil","family":"Aydin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alpkon","family":"Torun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmet Emin","family":"Aray\u0131c\u0131","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ozan","family":"Bozkurt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,23]]},"reference":[{"issue":"1","key":"6558_CR1","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1186\/s40779-022-00371-6","volume":"9","author":"XT Zeng","year":"2022","unstructured":"Zeng XT, Jin YH, Liu TZ et al (2022) Clinical practice guideline for transurethral plasmakinetic resection of prostate for benign prostatic hyperplasia (2021 Edition). Mil Med Res 9(1):14. https:\/\/doi.org\/10.1186\/s40779-022-00371-6","journal-title":"Mil Med Res"},{"issue":"8","key":"6558_CR2","doi-asserted-by":"publisher","first-page":"e75432","DOI":"10.7759\/cureus.75432","volume":"17","author":"M Ashhad","year":"2025","unstructured":"Ashhad M, Khalil U, Abbasi S et al (2025) Therapeutic Efficacy and Complication Profile of Monopolar Transurethral Resection of the Prostate (TURP) in the Management of Bladder Outlet Obstruction. Cureus 17(8):e75432. https:\/\/doi.org\/10.7759\/cureus.75432","journal-title":"Cureus"},{"issue":"2","key":"6558_CR3","doi-asserted-by":"publisher","first-page":"e0313557","DOI":"10.1371\/journal.pone.0313557","volume":"20","author":"WM Wan Mokhter","year":"2025","unstructured":"Wan Mokhter WM, Duan X, Yang J et al (2025) Construction of a nomogram to predict urethral stricture after transurethral resection of the prostate: A retrospective cohort study. PLoS ONE 20(2):e0313557. https:\/\/doi.org\/10.1371\/journal.pone.0313557","journal-title":"PLoS ONE"},{"issue":"1","key":"6558_CR4","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1007\/s00345-024-05017-x","volume":"42","author":"E Alt\u0131nta\u015f","year":"2024","unstructured":"Alt\u0131nta\u015f E, \u015eahin A, Babayev H et al (2024) Machine learning algorithm predicts urethral stricture following transurethral prostate resection. World J Urol 42(1):335. https:\/\/doi.org\/10.1007\/s00345-024-05017-x","journal-title":"World J Urol"},{"issue":"1","key":"6558_CR5","doi-asserted-by":"publisher","first-page":"E14","DOI":"10.5489\/cuaj.8015","volume":"17","author":"M Elsaqa","year":"2023","unstructured":"Elsaqa M, Serag M, Leenlani N et al (2023) The incidence of urethral stricture and bladder neck contracture with transurethral resection vs. holmium laser enucleation of prostate: A matched, dual-center study. Can Urol Assoc J 17(1):E14\u201320. https:\/\/doi.org\/10.5489\/cuaj.8015","journal-title":"Can Urol Assoc J"},{"issue":"2","key":"6558_CR6","doi-asserted-by":"publisher","first-page":"302","DOI":"10.1590\/S1677-5538.IBJU.2014.0500","volume":"42","author":"H Tao","year":"2016","unstructured":"Tao H, Jiang YY, Jun Q et al (2016) Analysis of risk factors leading to postoperative urethral stricture and bladder neck contracture following transurethral resection of prostate. Int Braz J Urol 42(2):302\u2013311. https:\/\/doi.org\/10.1590\/S1677-5538.IBJU.2014.0500","journal-title":"Int Braz J Urol"},{"issue":"1","key":"6558_CR7","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1590\/1806-9282.20210744","volume":"68","author":"F Afandiyev","year":"2022","unstructured":"Afandiyev F, Ugurlu O (2022) Factors predicting the development of urethral stricture after bipolar transurethral resection of the prostate. 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Indian J Urol 35(1):41\u201347. https:\/\/doi.org\/10.4103\/iju.IJU_114_18","journal-title":"Indian J Urol"}],"container-title":["World Journal of Urology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00345-026-06558-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00345-026-06558-z","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00345-026-06558-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T11:20:21Z","timestamp":1782213621000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00345-026-06558-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,23]]},"references-count":9,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["6558"],"URL":"https:\/\/doi.org\/10.1007\/s00345-026-06558-z","relation":{},"ISSN":["1433-8726"],"issn-type":[{"value":"1433-8726","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,23]]},"assertion":[{"value":"23 February 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 June 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they have no competing interests or conflicts of interest to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Ethical approval for this retrospective study was obtained from the Dokuz Eylul University Interventional Research Ethics Committee (Approval No. 2023\/05\u201323). All procedures adhered to the ethical principles outlined in the Declaration of Helsinki and its amendments. Written informed consent to participate was obtained from all patients (or their legal guardians) whose retrospective records were included in this study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval and consent to participate"}},{"value":"Written informed consent was obtained from the participants (or their legal guardians) for the publication of their clinical data and outcomes in this article.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}}],"article-number":"450"}}