Evaluating complications for surgery after benign prostate enlargement

The study evaluated the complications of surgery for benign prostatic enlargement (BPE) and which factors influence them. The main finding was that surgery complications increased over the years and in patients with prior medical therapy. 

BPE is a non-cancerous increase in the size of the prostate gland. This leads to urinary symptoms such as difficulty in beginning urination or frequent nighttime urination. Medical therapy and careful observation (conservative therapy) can manage patients with BPE. When both therapies fail, prostate surgery can be performed. However, surgery can have complications. It is important to evaluate which factors affect complications for BPE surgery.

The study analyzed the medical records of 52,162 men who underwent BPE surgery. 87% of men underwent transurethral resection of the prostate (TURP) surgery. The complications were measured for 30 days after surgery. Factors that influenced the occurrence of surgery complications were evaluated.

Overall, 2828 complication events were reported during the first 30 days. The most common BPE-related complication was obstruction of urine-flow, bleeding, and infection. Of the non-BPE complications, the most common was heart and blood vessel problems.

The complication rate increased with the patient’s age. Patients aged 80 or older had a 39% higher risk of complications. Patients aged 70-79 had a 30% higher risk of surgery complications, while 66-69-year-old men had a 20% higher risk of complications.

Increased complication rates were associated with medication use before surgery. Alpha-blockers such as tamsulosin (Flomax) and silodosin (Rapaflo) were associated with a 0.5% higher risk of surgery complications. Medications to prevent blood clots were associated with a 27% increased risk of complications after BPE surgery.

The authors concluded that more advanced age and medical therapy before surgery were associated with higher complication risks after BPE surgery. 

This study was retrospective, meaning that it looked back in time to analyze patients’ data. Also, it was conducted only on patients in Ontario, Canada. Further controlled studies in more diverse populations are needed for stronger evidence.