Risk Factors Analysis of Perioperative Complications in Elderly Patients Undergoing Transurethral Prostatectomy for Benign Prostatic Hyperplasia
Lan Xiaoda
Han Jianing
Jiang Rui
Che Xinyan
Yang Kunlin
Zuo Chao
Zhang Qian
Xiao Yunxiang
Zhang Kai
Meng Yisen
Abstract：Objective:To investigate the perioperative complications and their associated risk factors in elderly patients with benign prostatic hyperplasia(BPH).Methods:A retrospective analysis was conducted on 3,597 pa-tients who underwent transurethral prostate surgery for BPH at the Department of Urology,Peking University First Hospital,between January 2013 and January 2023.Among them,430 patients aged≥80 years(median age 82 years)were included,consisting of 346 patients who underwent transurethral resection of the prostate(TURP)and 84 patients who underwent transurethral laser prostatectomy.Of these,83 patients(19.3%)developed perioperative complications,while 347 patients(80.7%)had no complication.The incidence,types,and severity of complications were classified using the Clavien-Dindo grading system.Univariate and multivariate Logistic regression analyses were performed to identify the risk factors for perioperative complications and those with a higher incidence.Results:Com-pared with patients without complications,those who experienced perioperative complications had significantly longer median hospital stays(3 days vs.4 days)and catheter removal times(4 days vs.6 days)(P<0.001).Multivariate re-gression analysis revealed that tissue resection weight(OR=1.011,95%CI:1.001-1.020,P=0.026),diabetes(OR=1.946,95%CI:1.096-3.455,P=0.023),and preoperative urinary retention(OR=1.784,95%CI1.049-3.032,P=0.033)were associated with perioperative complications in elderly patients.Bleeding and infection were the most common complications.Multivariate analysis showed that bleeding was associated with surgical method(OR=0.207,95%CI:0.056-0.768,P=0.019)and tissue resection weight(OR=1.031,95%CI:1.019-1.044,P<0.001),while postoperative infection was associated with diabetes(OR=2.624,95%CI:1.187-5.804,P=0.017)and surgi-cal duration(OR=1.011,95%CI:1.002-1.020,P=0.015).According to the Clavien-Dindo classification,15 pa-tients(3.5%)had grade I complications,including 11 TURP patients and 4 laser prostatectomy patients;61 patients(14.2%)had grade II complications,including 48 TURP patients and 13 laser prostatectomy patients;7 patients(1.6%)had grade III or IV complications,all of whom underwent TURP;no grade V complications were observed.Conclusion:Tissue resection weight,diabetes,preoperative urinary retention,and surgical duration are independent risk factors for perioperative complications in elderly patients undergoing transurethral prostate surgery.Transurethral laser prostatectomy is associated with a lower incidence of grade III/IV severe complications and bleeding-related complications,making it a more appropriate surgical option for elderly patients with BPH requiring surgery.
Keywords：benign prostatic hyperplasia(bph)transurethral resection of the prostate(turp)laser enucleation of the prostate(lep)perioperative complicationselderly patients
Publication Date：2025-02-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：8( 38-45 )