The Particulars: As the population ages, it is important to understand which patients are at risk for postoperative complications and who might be better treated with conservative management when caring for lower urinary tract symptoms. However, data are lacking on predictors of morbidity following surgical treatment of benign prostatic hyperplasia (BPH).
Data Breakdown: Study investigators examined morbidity and mortality associated with transurethral resection of the prostate (TURP), laser vaporization of the prostate (LVP), and laser enucleation of the prostate (LEP) using a large national database. Overall, no significant differences in complications or perioperative mortality were observed between the three surgical groups. However, LVP was associated with decreased need for blood transfusions, risk of prolonged lengths of stay (LOS), and re-intervention rates. LEP was also associated with a decreased risk of prolonged LOS. Advanced age at surgery, non-Caucasian race, and smoking increased patients’ risk of morbidity and mortality. Conversely, normal preoperative albumin levels and higher preoperative hematocrit levels were predictors of fewer complications overall and lower perioperative mortality.
Take Home Pearls: TURP, LVP, and LEP all appear to be safe for the treatment of BPH. Age, race, and smoking status appear to help predict the types of outcomes following these BPH surgeries.