Improvement in mortality and morbidity in transurethral resection of the prostate over 17 years in a single center

Abstract

Background and purpose: Various improvements in the technique of transurethral resection of the prostate (TURP) have helped to reduce morbidity and mortality over the years. In this retrospective study, developments in the perioperative course in a single center were analyzed.

Patients and methods: A retrospective chart analysis was performed on 399 patients undergoing TURP in our institution between 1987 and 1997, summarized as group 1, and 550 patients operated on between 1997 and 2004, summarized as group 2. Personal data, preoperative findings, intraoperative and postoperative complications, and outcomes in the two groups were compared.

Results: Average patient age, preoperative peak flow, residual volume, size of the prostate, and operation time did not differ statistically, whereas the amount of resected tissue was slightly higher in group 1 (30.1 g v 26.5 g). The mortality rate dropped from 0.5% in group 1 to 0 in group 2. Intraoperative bleeding necessitating transfusion (20.3% v 3.8%), capsule perforation (17.3% v 6.2%), and postoperative urinary-tract infections (37.1% v 6.2%) were significantly reduced in group 2. The incidence of TUR syndrome (2.0% v 1.6%) and severe anaesthesiology complications (1.8% v 0.9%) were only insignificantly lower in group 2. Postoperative bleeding, recatheterization, reintervention, and nonspecific complications remained unchanged, while the incidence of grade II or III stress incontinence and the postoperative hospital stay were reduced in group 2.

Conclusions: Our study gives data on a contemporary TURP series and outlines a development toward fewer perioperative complications.