BPH surgery complications underestimated in trials

Practice complication rates following surgical treatment for BPH are higher than indicated by clinical trials, according to a study presented here.

In addition, re-intervention was required in nearly 5% of cases of transurethral resection of the prostate, researchers found.

Investigators conducted a prospective analysis of a French national patient registry, reviewing 262,898 patients who underwent surgery for BPH, to assess the actual complication rate following surgical management of bladder outlet obstruction (BOO)/BPH.

"Patients should be advised that subsequent surgery after initial BPH surgical management is not rare," said first author Jean-Nicolas Cornu, MD, of Tenon Hospital in Paris.

Dr. Cornu and colleagues reviewed the database from 2004 to 2007 for patients who underwent surgery for BPH, including TURP and open prostatectomy (OP). The authors also assessed all subsequent surgical procedures related to complications (clot retention removal, urinary incontinence, stricture surgery) or re-interventions for BPH.

The total number of procedures during the study period was 262,989, of which the vast majority were TURPs. Re-intervention for BOO persistence and/or recurrence was performed in 4.77% of cases of TURP and 1.92% of OP cases, Dr. Cornu reported. Median follow-up was approximately 2 years.

Surgery for clot retention following TURP was performed in 3.4% of cases and following OP in 3.7% of cases. Surgery for incontinence was done following TURP in 1.8 cases per thousand and following OP in 0.9 cases per thousand. Surgery for urethral stenosis following TURP was performed in 2.7% of cases and following OP in 1.3% of cases.

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