UK national bladder outlet obstruction surgery snapshot audit

Area of Science:

• Urology
• Surgical Outcomes
• Patient Assessment

Background:

• Bladder outlet obstruction (BOO) significantly impacts men's lower urinary tract symptoms.
• Surgical interventions are common for managing BOO, with evolving procedural options.
• Preoperative assessment and perioperative outcomes are crucial for evaluating BOO surgery efficacy.

Purpose of the Study:

• To evaluate the preoperative assessment practices and perioperative outcomes of men undergoing BOO surgery in the UK.
• To identify areas for improvement in the management of BOO patients.

Main Methods:

• Retrospective cohort study of 1456 men undergoing BOO surgery across 105 UK hospitals.
• Data collected on preoperative status, surgical procedures, and 30-day postoperative outcomes.
• Analysis included complication rates, re-admissions, and symptom improvement (International Prostate Symptom Score).

Main Results:

• 42% of men were catheter-dependent preoperatively; only 4% remained so postoperatively.
• Bipolar transurethral resection of the prostate (TURP) was the most common procedure (38%).
• Overall complication rate was 5%, with Clavien-Dindo Grade ≥III complications in only 1%; minimally invasive procedures showed comparable symptom improvement to TURP.

Conclusions:

• BOO surgery in the UK demonstrates favorable safety and effectiveness.
• Adherence to preoperative assessment guidelines for lower urinary tract symptoms is suboptimal and needs enhancement.
• Despite procedural shifts, current BOO surgical treatments provide significant symptom relief and are well-tolerated.