{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T05:45:58Z","timestamp":1791870358127,"version":"4.3.4"},"reference-count":75,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T00:00:00Z","timestamp":1750377600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>\n                    The transurethral route is the access of choice for benign prostatic hyperplasia (BPH) surgical treatment. Transurethral resection of the prostate (TURP) has been the gold standard in surgical intervention for BPH; however, the advent of novel surgical techniques and the exploration of new energy sources in recent decades have seen this primacy contested. Nevertheless, the transurethral route harbors numerous challenges and pitfalls that can pose significant risks even for the most experienced endoscopic urologists. Complications associated with transurethral access are well documented yet often underestimated by endoscopic surgeons, primarily because the pathological conditions arising from transurethral surgery typically fall within the realm of those specializing in genitourinary reconstructive surgery. This narrative review describes and critically discusses the specific pitfalls associated with transurethral surgery for BPH. Urethral strictures, transient or permanent postoperative incontinence, reintervention, and\n                    <jats:italic toggle=\"yes\">de novo<\/jats:italic>\n                    \/persistent lower urinary tract symptoms (LUTS) represent the main complications of transurethral treatments for BPH. These problems still stand as the foremost challenge for all endoscopists despite recent technological advancements. The use of increasingly miniaturized instruments, more mindful energy application, sphincter-sparing enucleation techniques, and the advent of so-called minimally invasive surgical techniques (MISTs) all contribute to a more conscious and anatomically respectful transurethral approach. An endoscopic transvesical suprapubic access may be another alternative strategy to minimize the complications of transurethral route in the future.\n                  <\/jats:p>","DOI":"10.4103\/aja202523","type":"journal-article","created":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T08:00:23Z","timestamp":1750406423000},"page":"46-56","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["The dark side of transurethral access for LUTS\/BPH surgery: a narrative review"],"prefix":"10.4103","volume":"28","author":[{"given":"Bruno","family":"Bucca","sequence":"first","affiliation":[{"name":"Department of Urology, Sapienza University of Rome, Policlinico Umberto I Hospital, Rome 00161, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Gozzi","sequence":"additional","affiliation":[{"name":"Department of Urology, CityClinic, Bolzano 39100, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca Matteo","family":"Gobbi","sequence":"additional","affiliation":[{"name":"Department of Urology, Sapienza University of Rome, Policlinico Umberto I Hospital, Rome 00161, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugenio","family":"Bologna","sequence":"additional","affiliation":[{"name":"Department of Urology, Sapienza University of Rome, Policlinico Umberto I Hospital, Rome 00161, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie Claire","family":"Licari","sequence":"additional","affiliation":[{"name":"Department of Urology, Sapienza University of Rome, Policlinico Umberto I Hospital, Rome 00161, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Asero","sequence":"additional","affiliation":[{"name":"Department of Urology, Sapienza University of Rome, Policlinico Umberto I Hospital, Rome 00161, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orietta","family":"Dalpiaz","sequence":"additional","affiliation":[{"name":"Department of Urology, Hochsteiermark Hospital, Leoben 8700, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Alber","sequence":"additional","affiliation":[{"name":"Department of Urology, Hochsteiermark Hospital, Leoben 8700, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Calarco","sequence":"additional","affiliation":[{"name":"Department of Urology, San Carlo di Nancy Hospital, GVM Care and Research, Rome 00165, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Martini","sequence":"additional","affiliation":[{"name":"Department of Urology, San Filippo Neri Hospital, Rome 00135, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrizio","family":"Presicce","sequence":"additional","affiliation":[{"name":"Department of Urology, San Filippo Neri Hospital, Rome 00135, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,6,20]]},"reference":[{"key":"R1-20260122","doi-asserted-by":"crossref","first-page":"2255","DOI":"10.1007\/s00345-021-03607-7","article-title":"The state of TURP through a historical lens","volume":"39","author":"Strebel","year":"2021","journal-title":"World J Urol"},{"key":"R2-20260122","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1016\/j.eururo.2023.04.008","article-title":"Summary paper on the 2023 European Association of Urology guidelines on the management of non-neurogenic male lower urinary tract symptoms","volume":"84","author":"Gravas","year":"2023","journal-title":"Eur Urol"},{"key":"R3-20260122","doi-asserted-by":"crossref","first-page":"1066","DOI":"10.1016\/j.eururo.2014.06.017","article-title":"A systematic review and meta-analysis of functional outcomes and complications following transurethral procedures for lower urinary tract symptoms resulting from benign prostatic obstruction:an update","volume":"67","author":"Cornu","year":"2015","journal-title":"Eur Urol"},{"key":"R4-20260122","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1038\/s41391-024-00841-z","article-title":"Incidence and management of BPH surgery-related urethral stricture:results from a large U. 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