Immediate and postoperative complications of transurethral prostatectomy in the 1990s

Purpose: We compare the morbidity, mortality, hospitalization and urethral catheter time of contemporary transurethral prostatectomy to historical ser ies, and evaluate recent trends in hospitalization and urethral catheter ti me during the last 8 years. Materials and Methods: A retrospective chart review of 520 consecutive pati ents who underwent transurethral prostatectomy between 1991 and 1998 at a s ingle institution for symptomatic benign prostatic hyperplasia was performe d. Inpatient and outpatient charts, clinic records, operative reports and d ischarge summaries were reviewed. For each patient 43 data points were coll ected. Telephone followup was performed when data were lacking. All retriev ed data were compiled in a computer database. Perioperative and late postop erative morbidity and mortality, hospitalization and urethral catheter time were analyzed. Results: A total of 520 patients were identified with an average age of 67 years (range 44 to 89). Significant co-morbidity (2 or more co-morbid disea se processes) was identified preoperatively in 30.3% of the patients. The m ost common indications for transurethral prostatectomy were lower urinary t ract symptoms (80.9%) and urinary retention (15.2%). Average preoperative I nternational Prostate Symptom Score was 23.8. Average weight of resected ti ssue was 18.8 gm. There was no perioperative patient mortality. Blood trans fusion rate was 0.4%. The rate of intraoperative and immediate postoperativ e complications was 2.5% and 10.8%, respectively. Average hospital stay was 2.4 days, and 1.1 from 1997 through 1998. The rate of late postoperative c omplication was 8.5% and the average postoperative symptom score was 6.4 wi th an average followup of 42 months (range 6 to 84). Conclusions: Contemporary perioperative and postoperative complications of transurethral prostatectomy are significantly lower than rates in historica l series. The average hospital stay and urethral catheter time have steadil y decreased during the last 8 years.