Transurethral Resection of the Prostate (TURP)

The aim of this clinical trial is to evaluate the effect of detrusor underactivity on the functional and symptomatic outcomes following transurethral resection of the prostate (TURP) in benign prostatic hyperplasia patients presenting with chronic urinary retention. The main questions it aims to answer are: Will they restore spontaneous voiding? They will be divided into 2 comparative groups (each group 45 patients) based on detrusor contractility. * Group (A) consists of patients with normal detrusor (bladder contractility index more than 100). * Group (B) consists of patients with underactive detrusor (bladder contractility index less than 100).

Spinal anesthesia is commonly used in transurethral prostate resection (TUR-P) surgeries; however, post-spinal hypotension remains a frequent and clinically significant complication, particularly in elderly patients. Early prediction of hypotension may allow timely interventions and improve patient safety. This prospective observational study aims to evaluate the predictive value of preoperative ultrasound-based inferior vena cava collapsibility index (IVC-CI) and femoral vein collapsibility index (FVCI) for post-spinal hypotension in patients undergoing elective TUR-P under spinal anesthesia. Before spinal anesthesia, IVC and femoral vein measurements will be obtained using ultrasonography. Hemodynamic parameters will be recorded before and after spinal anesthesia, and the occurrence of hypotension will be assessed according to predefined criteria. The study seeks to compare the diagnostic performance of IVC-CI and FVCI in predicting post-spinal hypotension and to identify potential clinical predictors associated with hypotension in this patient population.