Michael Lotterstätter1, Stephan Seklehner2,3, Florian Wimpissinger4,5, Jozsef Gombos6, Jasmin Bektic7, Philipp Stolzlechner7, Sarah Laimer8, Thomas R W Herrmann9,10,11, Stephan Madersbacher1, Lukas Lusuardi3, Manuela Sieberer3, Christian Ramesmayer12. 1. Department of Urology, Klinik Favoriten, Vienna, Austria. 2. Department of Urology, Landesklinikum Baden-Mödling, Baden, Austria. 3. Department of Urology and Andrology, Paracelsus Medical University, Müllner Hauptstraße 48, 5020, Salzburg, Austria. 4. Department of Urology, Landesklinikum Mistelbach, Mistelbach, Austria. 5. Department of Urology, Rudolfstiftung Hospital, Vienna, Austria. 6. Department of Urology, Landesklinikum Wiener Neustadt, Wiener Neustadt, Austria. 7. Department of Urology, Medical University Innsbruck, Innsbruck, Austria. 8. Department of Urology, Tauernklinikum Zell am See, Zell am See, Austria. 9. Department of Urology, Spital Thurgau AG, Kantonspital Frauenfeld, Frauenfeld, Switzerland. 10. Urology Stellenbosch University, Western Cape, South Africa. 11. Hannover Medical Scholl MHH, Carl Neuberg Str. 1 30625, Hannover, Germany. 12. Department of Urology and Andrology, Paracelsus Medical University, Müllner Hauptstraße 48, 5020, Salzburg, Austria. c.ramesmayer@salk.at.
Abstract
PURPOSE: To determine the safety and efficacy of transurethral resection of the prostate (TUR-P) in patients 85 years or older. METHODS: In this retrospective, multicentre study, patients equal or older than 85 years at the time of surgery (2015-2020) were included. Several pre-, peri- and postoperative parameters were collected. The main outcome criterion was spontaneous voiding with a post-void residual (PVR) volume < 100 ml at dismission and at 12 months after surgery. RESULTS: One hundred sixty-eight patients (median age: 87 years, interquartile range [IQR]: 86-89) were recruited. The patients took on average 5.2 permanent medications (3-8), 107 (64%) were anticoagulated preoperatively and neurological co-morbidities were present in 29 (17%). The indication for surgery was recurrent urinary retention in 66.3% (n = 110) with a mean retention volume of 849 ml. The mean PVR volume of the remaining 35% was 146 ml. Surgery was successfully completed in all patients. A perioperative surgical revision had to be performed in 3% and 13 patients (7.7%) required blood transfusion. After catheter removal, 85% of patients were able to void spontaneously with a PVR < 100 ml, and 14.3% were dismissed with a catheter. Twelve months data were available for 93 patients (55%). Of this cohort, 78 (83.9%) were able to void spontaneously with a PVR < 100 ml, 12 (12.9%) were on permanent catheterization. One patient (0.6%) died perioperatively. The only significant factor associated with an unsuccessful outcome was the number of permanent medications (6.8 vs. 5.0, p = 0.005). CONCLUSION: This retrospective multicentre study documents the safety and efficacy of TURP (monopolar and bipolar) in the old-old cohort.
PURPOSE: To determine the safety and efficacy of transurethral resection of the prostate (TUR-P) in patients 85 years or older. METHODS: In this retrospective, multicentre study, patients equal or older than 85 years at the time of surgery (2015-2020) were included. Several pre-, peri- and postoperative parameters were collected. The main outcome criterion was spontaneous voiding with a post-void residual (PVR) volume < 100 ml at dismission and at 12 months after surgery. RESULTS: One hundred sixty-eight patients (median age: 87 years, interquartile range [IQR]: 86-89) were recruited. The patients took on average 5.2 permanent medications (3-8), 107 (64%) were anticoagulated preoperatively and neurological co-morbidities were present in 29 (17%). The indication for surgery was recurrent urinary retention in 66.3% (n = 110) with a mean retention volume of 849 ml. The mean PVR volume of the remaining 35% was 146 ml. Surgery was successfully completed in all patients. A perioperative surgical revision had to be performed in 3% and 13 patients (7.7%) required blood transfusion. After catheter removal, 85% of patients were able to void spontaneously with a PVR < 100 ml, and 14.3% were dismissed with a catheter. Twelve months data were available for 93 patients (55%). Of this cohort, 78 (83.9%) were able to void spontaneously with a PVR < 100 ml, 12 (12.9%) were on permanent catheterization. One patient (0.6%) died perioperatively. The only significant factor associated with an unsuccessful outcome was the number of permanent medications (6.8 vs. 5.0, p = 0.005). CONCLUSION: This retrospective multicentre study documents the safety and efficacy of TURP (monopolar and bipolar) in the old-old cohort.
Authors: K Eredics; C Wehrberger; A Henning; S Sevcenco; M Marszalek; M Rauchenwald; C Falkensammer; U Stoces; S Madersbacher; M Horetzky; T Kunit; L Lusuardi Journal: Prostate Cancer Prostatic Dis Date: 2021-09-29 Impact factor: 5.554