Standard surgical treatment for benign prostatic hyperplasia is safe for patients over 75 years: Analysis of 100 cases from a high-volume urologic center

Abstract

OBJECTIVES:In this study, we aimed to determine the complications of standard surgical treatments among patients over 75 years in a high-volume urologic center.METHODS:We analyzed 100 consecutive patients older than 75 years who had undergone transurethral prostatic resection of the prostate or open prostatectomy for treatment of benign prostatic hyperplasia from January 2008 to March 2010. We analyzed patient age, prostate volume, prostate-specific antigen level, international prostatic symptom score, quality of life score, urinary retention, co-morbidities, surgical technique and satisfaction with treatment.RESULTS:Median age was 79 years. Forty-eight patients had undergone transurethral prostatic resection of the prostate, and 52 had undergone open prostatectomy. The median International Prostatic Symptom Score was 20, the median prostate volume was 83 g, 51% were using an indwelling bladder catheter, and the median prostate-specific antigen level was 5.0 ng/ml. The most common comorbidities were hypertension, diabetes and coronary disease. After a median follow-up period of 17 months, most patients were satisfied. Complications were present in 20% of cases. The most common urological complication was urethral stenosis, followed by bladder neck sclerosis, urinary fistula, late macroscopic hematuria and persistent urinary incontinence. The most common clinical complication was myocardial infarction, followed by acute renal failure requiring dialysis. Incidental carcinoma of the prostate was present in 6% of cases. One case had urothelial bladder cancer.CONCLUSIONS:Standard surgical treatments for benign prostatic hyperplasia are safe and satisfactory among the elderly. Complications are infrequent, and urethral stenosis is the most common. No clinical variable is associated with the occurrence of complications.

Holmium Laser Enucleation of the Prostate is Safe for Patients Above 80 Years: A Prospective Study

“…As Marmiroli et al [ 11 ] reported, the prevalence of hypertension, a history of surgery, and other complications such as cardiovascular disease and neurologic disease increased in older patients significantly. Several baseline characteristics of the patients were significantly different among the 4 groups, including the presence of hypertension and urinary retention, total prostate volume, transitional zone volume, mean ASA score, and the number of patients using anticoagulation medications, which increased with age.…”

“…These results were consistent with those previously reported [ 12 ]. Oral anticoagulant use independently affects TURP outcome, with longer hospital stay, and higher rates of bleeding, blood transfusion, late hematuria, and thromboembolic events [ 11 ]. As Mmeje et al [ 10 ] reported, the overall blood transfusion rate was highest in patients ≥80 years (11%) who underwent HoLEP.…”

Health‐related quality of life in patients undergoing TURP: Translating evidence into urological nursing practice

“…98,99 A study combining a follow-up of greater than 15 years after TURP, stated satisfaction rates of 79% in regards to micturition. 100 Due to the significance of quality of life domain in urology field, a targeted health education program and training must be taken into consideration due to some of the healthcare professionals have a lack of knowledge related to HRQOL assessment, analysis, and interpretation. 101 It is therefore paramount for urological nurses to communicate and provide an intensive consultation relating to the realistic expectations of quality of life aspect to those having a his- 103 This approach should also be incorporated in a TURP nursing care plan, and patients along with their families must participate-particularly in decision-making relating to the finest interventions.…”

A High-Fidelity Phantom for the Simulation and Quantitative Evaluation of Transurethral Resection of the Prostate

“…Procedures involve transurethral resection of the prostate (TURP) and holmium laser enucleation of the prostate (HoLEP), 19 of which TURP has been the benchmark therapy for BPH. 3,17 TURP involves the resection of the abnormally enlarged prostate tissue and involves the use of a wire loop that is heated by an alternating electrical current. 2 Typically, a rigid endoscope is inserted through the urethra of the patient and the prostate tissue is resected under endoscopic observation.…”