Predictors of Postoperative Complications of Transurethral Resection of the Prostate in a Resource-Poor Setting*

Predictors of Postoperative Complications of Transurethral Resection of the Prostate in a Resource-Poor Setting*
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Title:Predictors of Postoperative Complications of Transurethral Resection of the Prostate in a Resource-Poor Setting*
Author/Abstract:

Aladin B. Plaza, MD1 and Marie Carmela M. Lapitan, MD, FPUA1,2,3
1 Division of Urology, Department of Surgery, Philippine General Hospital, University of the Philippines Manila 
2 Department of Surgery, College of Medicine, University of the Philippines Manila
3 National Institutes of Health, University of the Philippines Manila

Introduction: Transurethral resection of the prostate (TURP) is the gold standard in the surgical
management of bladder outlet obstruction caused by an enlarged prostate. Morbidity rate is reported at 1-3%. In developed countries, this rate has decreased during the last three decades because of the technological improvements. This study aimed to determine the incidence of postoperative complications of TURP in a setting where not all technological advancements are available. It also identified the risk factors associated with the occurrence of complications.

Methods: This is a prospective cohort study of 408 patients who underwent TURP at the Philippine
General Hospital from 2010-2012. Age, presence of medical conditions, pre-operative intake of
alpha adrenergic blockers and alpha reductase inhibitors, duration of pre-operative urinary retention, gland size, resection time, volume of resected prostatic tissue, preoperative presence of catheter related infection and presence of capsular perforation were evaluated in terms of their association with the occurrence of complication using univariate analysis and multivariate logistic regression.

Results: The overall complication rate was 27.7% (113/408). TURP syndrome was the most common complication, noted in 9.6% (39/408) of patients. Factors significantly associated with the
development of complications were the presence of urinary tract infection preoperatively, presence
of hypertension, resection time of more than 60 minutes and capsular perforation. TURP syndrome
was found to be significantly associated with the preoperative intake of ARI, capsular perforation,
prostate tissue of more than 50 grams and resection time of more than 60 minutes.

Conclusions: The complication rate of TURP is higher in this study compared to published literature. Risk factors associated with complications were similar to those in previous reports, including presence of urinary tract infection preoperatively, presence of hypertension, and resection time of more than 60 minutes and capsular perforation and prostate tissue of more than 50 grams.

Key words: transurethral resection of the prostate, postoperative complications

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