Older Age Does Not Have an Impact on Postoperative Complication Risk Following Transurethral Resection of the Bladder...

The incidence of bladder cancer has been increasing within the aging population. Transurethral resection of bladder tumor (TURBT) is the first-line treatment for bladder cancer, serving both diagnostic and therapeutic purposes. In this study, we aimed to investigate the incidence and predictors of postoperative complications following TURBT in a general hospital with a high proportion of older patients.

We analyzed 141 Japanese patients retrospectively who had undergone TURBT for clinically diagnosed bladder cancer between January 2018 and December 2023. Postoperative complications occurring within 30 days were reviewed from medical records, and risk factors were evaluated.

Postoperative complications were observed in 49 patients (34.8%), with 28 patients (20%) classified as Clavien-Dindo grade I and 21 (15%) as grade II or higher. In univariable analysis, factors significantly associated with postoperative complications included older age (odds ratio [OR]: 1.04; p = 0.027), lower platelet count (OR: 0.91; p = 0.009), positive urine cytology (class III or higher) (OR: 2.69; p = 0.007), pathological T2 or higher stage (OR: 5.79; p = 0.013), larger tumor size (OR: 1.05; p = 0.005), and longer operative time (OR: 1.02; p = 0.009). In multivariable analysis, independent risk factors for postoperative complications were lower platelet count (OR: 0.89; p < 0.01), pathological T2 or higher (OR: 5.51; p = 0.03), and larger tumor size (OR: 1.05; p < 0.01). Notably, older age was not an independent risk factor.

TURBT appears feasible in older patients when performed by experienced surgeons. Age alone should not be considered a limiting factor for surgical eligibility.