Mortality after surgery for benign prostate hyperplasia: a nationwide cohort study

Area of Science:

• Urology
• Surgical Outcomes
• Public Health

Background:

• Benign prostate hyperplasia (BPH) affects a significant portion of the aging male population.
• Surgical interventions are common for managing BPH symptoms.
• Understanding postoperative mortality and associated risk factors is crucial for patient safety.

Purpose of the Study:

• To determine 90-day postoperative mortality rates following surgical treatment for BPH.
• To identify risk factors associated with mortality after BPH surgery.
• To compare mortality rates between different surgical approaches for BPH.

Main Methods:

• Retrospective analysis of a nationwide Finnish registry (2004-2014).
• Inclusion of patients undergoing partial prostate excision/resection (TURP, laser vaporization, open prostatectomy).
• Statistical analysis (univariable and multivariable regression) to assess risk factors including age, Charlson Comorbidity Index (CCI), operation type, and atrial fibrillation.

Main Results:

• A total of 39,320 patients were analyzed; transurethral resection of the prostate (TURP) was the most frequent procedure.
• The overall 90-day postoperative mortality rate was 1.10%, with excess mortality below 0.5% across age groups.
• Older age, higher CCI, and atrial fibrillation were significant risk factors for mortality. Laser procedures showed lower mortality (0.59%) compared to TURP (1.16%).

Conclusions:

• Elective BPH surgery is generally safe, but mortality risk escalates with patient age.
• Laser vaporization may be associated with a lower mortality rate than TURP.
• Individualized risk-benefit assessment is essential, and further comparative studies on surgical techniques are warranted.