DOES SIZE MATTER? EXPLORING THE LINK BETWEEN PENILE BIOMETRY AND URETHRAL MEATAL CALIBER FOR OPTIMAL RESECTOSCOPE SELECTION DURING TRANSURETHRAL RESECTION OF PROSTATE

Introduction: While multiple studies have indicated that the discrepancy between resectoscope size and urethral meatal caliber is a key contributor to post-TURP stricture formation, there is limited data on the average size of the external urethral meatus in adult males undergoing TURP, especially for the Indian population. Additionally, there is scarcity of information on methods of determining the urethral caliber without additional instrumentation. This information is vital for choosing the size of resectoscope sheath. Material And Methods: This prospective observational study was conducted over a period of 12 months in a tertiary care centre in Western India on male patients aged more than 45 years who underwent TURP for bladder outlet obstruction. Penile shaft biometry (measurement of width, circumference, and stretched length of the penis) was done under anaesthesia on the operating table and the size of the external urethral meatus was measured using a meatal calibrator. The data was analysed using relevant statistical tools. Results: A total of 92 patients were enrolled with a mean age of 68.8±9 years. The mean stretched penile length, penile width and penile circumference were found to be 10.8±1.8 cm, 3.5±0.5 cm and 8.8±1.7 cm in our subjects while the mean external urethral meatus size was 25.04±2.08 Fr. No significant correlation of stretched penile length, penile width and penile circumference was found with external urethral meatus size (p>0.05). Conclusions: Though our study did not reveal any significant correlation between penile characteristics and urethral meatal caliber, it showed that the average urethral meatal caliber in our study population (adult Indian male) is smaller than what has been reported in the existing literature highlighting the need to revaluate the instrument design for different populations.