S.P. Pasechnikov, Ya.M. Klimenko, A.A. Moallim

Risk assessment of early postoperative complications after transurethral resection of the prostate in patients with benign prostatic hyperplasia

In order to study the complications after TURP, the results of treatment of 266 patients with BPH were subjected to a comparative analysis, in which, in the period from 2015 to 2016, bipolar resection was performed in 72 cases and in 194 it was monopolar, including 141 and 125 - in an urgent and planned manner on the basis of urological departments of the Alexander Clinical Hospital in Kyiv. Complications were detected in 64,7% of patients, among which 48,2% had one, 29,0% - two, 16,9% - three and 5,5% - four - five. According to Claviиn-Dindo classification, 90,3% of them had I degree of severity, 1,2% - II and 7,5% - III degrees. There were no complications in 50,4 ± 4,4% and in 12,7 ± 3,2% of patients with planned and urgent hospitalization, respectively, as well as in 36,1±5,6% and 35,0 ± 3,4% at bi- and monopolar TURP, respectively; in their presence, I degree was in 58,3±5,8% and 59,3 ± 3,5% of patients, respectively, II stage - 2,7±1,7% only with bipolar and III - 2,7±1,7% and 5,7±1,6%, respectively. In the structure of complications after bipolar TURP, accumulation symptoms prevailed irrespective of the type of hospitalization to imperative demands, transient and stress urinary incontinence accounted for 75,0±5,8% of cases, with monopolar - their share was statistically lower: 55,0 ± 4,3 % for urgent and 68,4±6,1% for planned hospitalization, while the incidence of infectious and inflammatory complications was higher: 31,9% and 26,3% vs. 20,0% and 25,0%, respectively, with bipolar.

It has been established that patients with BPH at the age of 75 and older admitted in a hospital with a recurrent AUR and duration of LUTS and monotherapy with a-blockers more than 3 years, have an increased risk of postoperative complications after TURP.