Safety and effectivity of open simple prostatectomy in octogenarians: A single center experience

ABSTRACT

Objective: This study aimed to investigate the safety and effectiveness of open simple prostatectomy  (OSP) in patients older than 80 (i.e., octogenarians).

Material and Methods: Patients who underwent OSP in our center between  January 2012 and January 2018 constituted this study’s target population. The patients were evaluated by dividing the entire cohort into three age groups: 50-64, 65-79, and  ≥80. The study groups were compared regarding demographic features, preoperative clinical data, operative parameters, postoperative first-month and third-month uroflowmetric data, and short-term complication rates.  

Results: Preoperative persistent acute urinary retention and urethral catheterization rates were significantly higher in octogenarians than in the other patients. The groups were similar concerning intraoperative estimated blood  loss, blood transfusion rates, Clavien-Dindo Class≥3 complication rates and the general complication rate statistically. The comparative analysis revealed that the duration of catheterization was significantly longer in Group 2 and 3 than Group 1 (p=<0.001). The length of hospital stay was also significantly higher in octogenarians than the patients in Group 1 (p=0.003). Postoperative third-month IPSS valuee were significantly higher in octogenarians compared to the other groups (p=0.042).

Conclusion: Although OSP is an effective and safe surgical treatment method in octogenarians, its effectiveness is limited compared to other groups in terms of urethral catheter duration, length of hospital stay and IPSS scores. Before OSP, each patient should be managed by an individualized approach for lowering the procedure-related morbidity and mortality rates.

Keywords:  Benign prostatic hyperplasia, Open simple prostatectomy, Octogenarians

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ABSTRACT

Objective: This study aimed to investigate the safety and effectiveness of open simple prostatectomy  (OSP) in patients older than 80 (i.e., octogenarians).

Material and Methods: Patients who underwent OSP in our center between  January 2012 and January 2018 constituted this study’s target population. The patients were evaluated by dividing the entire cohort into three age groups: 50-64, 65-79, and  ≥80. The study groups were compared regarding demographic features, preoperative clinical data, operative parameters, postoperative first-month and third-month uroflowmetric data, and short-term complication rates.  

Results: Preoperative persistent acute urinary retention and urethral catheterization rates were significantly higher in octogenarians than in the other patients. The groups were similar concerning intraoperative estimated blood  loss, blood transfusion rates, Clavien-Dindo Class≥3 complication rates and the general complication rate statistically. The comparative analysis revealed that the duration of catheterization was significantly longer in Group 2 and 3 than Group 1 (p=<0.001). The length of hospital stay was also significantly higher in octogenarians than the patients in Group 1 (p=0.003). Postoperative third-month IPSS valuee were significantly higher in octogenarians compared to the other groups (p=0.042).

Conclusion: Although OSP is an effective and safe surgical treatment method in octogenarians, its effectiveness is limited compared to other groups in terms of urethral catheter duration, length of hospital stay and IPSS scores. Before OSP, each patient should be managed by an individualized approach for lowering the procedure-related morbidity and mortality rates.

Keywords:  Benign prostatic hyperplasia, Open simple prostatectomy, Octogenarians

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