Immediate and postoperative complications of transurethral prostatectomy in the 1990s

We compare the morbidity, mortality, hospitalization and urethral catheter time of contemporary transurethral prostatectomy to historical series, and evaluate recent trends in hospitalization and urethral catheter time during the last 8 years.

A retrospective chart review of 520 consecutive patients who underwent transurethral prostatectomy between 1991 and 1998 at a single institution for symptomatic benign prostatic hyperplasia was performed. Inpatient and outpatient charts, clinic records, operative reports and discharge summaries were reviewed. For each patient 43 data points were collected. Telephone followup was performed when data were lacking. All retrieved data were compiled in a computer database. Perioperative and late postoperative morbidity and mortality, hospitalization and urethral catheter time were analyzed.

A total of 520 patients were identified with an average age of 67 years (range 44 to 89). Significant co-morbidity (2 or more co-morbid disease processes) was identified preoperatively in 30.3% of the patients. The most common indications for transurethral prostatectomy were lower urinary tract symptoms (80.9%) and urinary retention (15.2%). Average preoperative International Prostate Symptom Score was 23.8. Average weight of resected tissue was 18.8 gm. There was no perioperative patient mortality. Blood transfusion rate was 0.4%. The rate of intraoperative and immediate postoperative complications was 2.5% and 10.8%, respectively. Average hospital stay was 2.4 days, and 1.1 from 1997 through 1998. The rate of late postoperative complication was 8.5% and the average postoperative symptom score was 6.4 with an average followup of 42 months (range 6 to 84).

Contemporary perioperative and postoperative complications of transurethral prostatectomy are significantly lower than rates in historical series. The average hospital stay and urethral catheter time have steadily decreased during the last 8 years.