Transurethral resection of the prostate in 85+ patients: a retrospective, multicentre study

Abstract

Purpose To determine the safety and efficacy of transurethral resection of the prostate (TUR-P) in patients 85 years or older. Methods In this retrospective, multicentre study, patients equal or older than 85 years at the time of surgery (2015–2020) were included. Several pre-, peri- and postoperative parameters were collected. The main outcome criterion was spontaneous voiding with a post-void residual (PVR) volume < 100 ml at dismission and at 12 months after surgery. Results One hundred sixty-eight patients (median age: 87 years, interquartile range [IQR]: 86–89) were recruited. The patients took on average 5.2 permanent medications (3–8), 107 (64%) were anticoagulated preoperatively and neurological co-morbidities were present in 29 (17%). The indication for surgery was recurrent urinary retention in 66.3% (n = 110) with a mean retention volume of 849 ml. The mean PVR volume of the remaining 35% was 146 ml. Surgery was successfully completed in all patients. A perioperative surgical revision had to be performed in 3% and 13 patients (7.7%) required blood transfusion. After catheter removal, 85% of patients were able to void spontaneously with a PVR < 100 ml, and 14.3% were dismissed with a catheter. Twelve months data were available for 93 patients (55%). Of this cohort, 78 (83.9%) were able to void spontaneously with a PVR < 100 ml, 12 (12.9%) were on permanent catheterization. One patient (0.6%) died perioperatively. The only significant factor associated with an unsuccessful outcome was the number of permanent medications (6.8 vs. 5.0, p = 0.005). Conclusion This retrospective multicentre study documents the safety and efficacy of TURP (monopolar and bipolar) in the old-old cohort.

Transurethral Resection of the Prostate (TRUP) for the Treatment of Benign Prostatic Hyperplasia (BPH) in Central Cote D’Ivoire: Indications and Results

“…The results of trans-urethral resection of the prostate (TURP) were considered good in the present study at 94.87%. This result is consistent with the success rates reported by various authors in the literature [8] [10] [13].…”

“…Our results are in line with the results of studies previously published in the literature showing that recourse to surgery for the treatment of benign prostatic hyperplasia is only decided if the patient presents progressive complications of the pathology [8] [9] [10] [11]. The indications for transurethral resection of the prostate (TURP) in the present study are in line with the recommendations of the American Urological Association in 2021.…”

“…In the present study, the average hospital stay was 3.75 days, compared with 6 days in the study by LOTTERSTATTER [8] and 2.1 days for GEREMEW [16]. This short hospital stay reflects the elegance of transurethral resection of the prostate (TURP).…”

Procedural Intervention for Benign Prostatic Hyperplasia in Men ≥ Age 70 Years – A Review of Published Literature

“…A recent multicenter retrospective study aimed to analyze the efficacy of TURP in patients 85 years and older (74% were bipolar, and 26% monopolar). 4 In this study, 66.3% of patients had an indwelling catheter pre-operatively due to recurrent urinary retention. Post procedure, 85% of patients were able to spontaneously void, and 85.7% of patients remained catheter free at 12-months.…”

Functional Outcome and Safety of Endoscopic Treatment Options for Benign Prostatic Obstruction (BPO) in Patients ≥ 75 Years of Age

“…A positive linear relationship (r = 0.5007) was observed between the use of anticoagulants or antiplatelet drugs and postoperative transfusions across all surgical techniques [ 19 , 22 , 23 , 31 , 32 , 33 , 34 , 35 ].…”