Background: Benign prostatic hyperplasia (BPH) is a non-malignant proliferation of periurethral prostatic tissue commonly seen in aging men, often causing lower urinary tract symptoms (LUTS).

Aim: to assess intraoperative and postoperative complications of TURP in Bujumbura.

Materials and Methods: A retrospective study was conducted over 30 months (Jan 2020 – June 2022), including all patients who underwent TURP for BPH at two hospitals in Bujumbura. Only complete medical records were included. Data were analyzed using Epi Info 7.2.2.6.

Results: Out of 143 prostate surgeries, 118 (82.5%) were TURPs. Mean age was 70.7 years (range: 51–90). Main symptoms: urinary retention (39%), frequency (28.8%), and dysuria (28%). Benign prostate was suspected in 87.3% on DRE; PSA <4 ng/ml in 66.9%. Prostate volume was 30–60 g in 60.2%. Only 29.7% had prior medical therapy. Catheter-dependent retention was the leading surgical indication (38.1%). Intraoperative complications occurred in 2.5%: capsular perforation (1.7%) and bulbar urethral injury (0.8%). Early postoperative complications: bladder spasms (10.2%), retention after catheter removal (6.8%), UTI (3.4%), and hematuria from eschar sloughing (1.7%). Average hospital stay was 5.1 days; catheterization duration was 2.95 days. Late complications: retrograde ejaculation (53.4%), recurrent LUTS (3.4%), urethral stricture (1.7%), prostatic fossa sclerosis (0.8%), bladder neck sclerosis (0.8%), and incontinence (0.8%).

Conclusion: TURP is safe and effective for BPH in Burundi. Despite low complication rates, adequate technical expertise and close postoperative monitoring are essential to reduce risks and improve outcomes.