nach oben

Erschienen in:

01.08.2013 | Urology - Original Paper

Contemporary monopolar and bipolar transurethral resection of the prostate: prospective assessment of complications using the Clavien system

verfasst von: Cosimo De Nunzio, Riccardo Lombardo, Riccardo Autorino, Antonio Cicione, Luca Cindolo, Rocco Damiano, Marco De Sio, Mario Falsaperla, Giorgio Franco, Mauro Gacci, Costantino Leonardo, Fabrizio Presicce, Andrea Tubaro

Erschienen in: International Urology and Nephrology | Ausgabe 4/2013

Einloggen, um Zugang zu erhalten

Abstract

Purpose

A modified version of the Clavien system has been recently suggested to allow a standardized assessment of complications associated with transurethral resection of the prostate (TURP). Aim of this multicentre study was to validate the use of this assessment tool in a contemporary cohort of patients undergoing monopolar or bipolar TURP.

Methods

Consecutive patients undergoing TURP in five Italian institutions from April 2011 to March 2012 were prospectively included in this study. Complications occurring within first postoperative month were recorded and graded according to the modified Clavien system. Univariate and binary logistic regression analysis were used for statistical analysis.

Results

Two hundred and ninety-five patients were included in the study. Overall, 47 complications were recorded in 44 patients. There was no difference in terms of postoperative complications between those who underwent monopolar TURP (27 pts; 9.2 %) versus those who underwent bipolar TURP (17 pts; 5.2 %, p = 0.142). Overall perioperative morbidity rate was 15.5 %. Most of the complications were Clavien type I (37 cases; 78 %) and II (6 cases; 12 %). High-grade complications were few as follows: Clavien type IIIb in two cases (4 %) and IV in two cases (4 %). No TURP-related deaths were reported. In the monopolar TURP group, a longer-operative time (OR 1.024; 95 % CI 1.007–1.040, p = 0.004) is an independent predictors of postoperative complications.

Conclusions

A modified Clavien system can be considered a practical and easily applicable tool in grading postoperative complications in patients undergoing TURP. Our findings confirm that TURP is a safe procedure associated with minimal perioperative morbidity.

Rassweiller JSM, Schulze M, Stock C, Teber B, De La Rosette J (2007) Bipolar transurethral resection of the prostate—technical modifications and early clinical experience. Minim Invasive Ther Allied Technol 16:11–21CrossRef

Iori F, Franco G, Leonardo C et al (2008) Bipolar transurethral resection of prostate: clinical and urodynamic evaluation. Urology 71:252–255PubMedCrossRef

AUA guideline on management of benign prostatic hyperplasia (2003) Chapter 1: Diagnosis and treatment recommendations. J Urol 170:530–547

Reich O, Gratzke C, Stief CJ (2006) Techniques and long-term results of surgical procedures for BPH. Eur Urol 49:970–978PubMedCrossRef

Rassweiler J, Teber D, Kuntz R, Hofmann R (2006) Complications of transurethral resection of the prostate (TURP)-incidence, management, and prevention. Eur Urol 50:969–979PubMedCrossRef

De Nunzio C, Cindolo L, Leonardo C et al (2013) Analysis of radical cystectomy and urinary diversion complications with the Clavien classification system in an Italian real life cohort. Eur J Surg Oncol. doi:10.1016/j.ejso.2013.03.008. pii:S0748-7983(13)00318-1

Mitropoulos D, Artibani W, Graefen M, Remzi M, Rouprêt M, Truss M (2013) Reporting and grading of complications after urologic surgical procedures: an ad hoc EAU guidelines panel assessment and recommendations. Actas Urol Esp 37:1–11PubMedCrossRef

Sokol DK, Wilson J (2008) What is a surgical complication? World J Surg 32:942–944PubMedCrossRef

Dindo D, Clavien PA (2008) What is a surgical complication? World J Surg 32:939–941PubMedCrossRef

10.

Bruce J, Russell EM, Mollison J, KruKowski ZH (2001) The measurement and monitoring of surgical adverse events. Health Technol Assess 5:1–194PubMed

11.

Clavien PA, Sanabria JR, Strasberg SM (1992) Proposed classification of complications of surgery with examples of utility in cholecystectomy. Surgery 111:518–526PubMed

12.

Clavien PA, Barkun J, de Oliveira ML et al (2009) The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg 250:187–196PubMedCrossRef

13.

Tefekli A, Ali Karadag M, Tepeler K et al (2008) Classification of percutaneous nephrolithotomy complications using the modified Clavien grading system: looking for a standard. Eur Urol 53:184–190PubMedCrossRef

14.

Mandal S, Sankhwar SN, Kathpalia R et al (2013) Grading complications after transurethral resection of prostate using modified Clavien classification system and predicting complications using the Charlson comorbidity index. Int Urol Nephrol 45:347–354PubMedCrossRef

15.

Mamoulakis C, Skolarikos A, Schulze M (2012) Results from an international multicentre double-blind randomized controlled trial on the perioperative efficacy and safety of bipolar vs monopolar transurethral resection of the prostate. BJU Int 109:240–248PubMedCrossRef

16.

Mamoulakis C, Efthimiou I, Kazoulis S, Christoulakis I, Sofras F (2011) The modified Clavien classification system: a standardized platform for reporting complications in transurethral resection of the prostate. World J Urol 29:205–210PubMedCrossRef

17.

Holtgrewe HL, Valk WL (1962) Factors influencing the mortality and morbidity of transurethral prostatectomy: a study of 2,015 cases. J Urol 87:450–459PubMed

18.

Madersbacher S, Lackner J, Brössner C, Röhlich M, Stancik I, Willinger M (2005) Prostate study group of the Austrian society of urology. Reoperation, myocardial infarction and mortality after transurethral and open prostatectomy: a nation-wide, long-term analysis of 23,123 cases. Eur Urol 47:499–504PubMedCrossRef

19.

Mamoulakis C, Schulze M, Skolarikos A et al (2013) Midterm results from an international multicentre randomised controlled trial comparing bipolar with monopolar transurethral resection of the prostate. Eur Urol 63:667–676PubMedCrossRef

20.

Madersbacher S, Marberger M (1999) Is transurethral resection of the prostate still justified? BJU Int 83:227–237PubMedCrossRef

21.

Issa MM (2008) Technological advances in transurethral resection of the prostate: bipolar versus monopolar TURP. J Endourol 22:1587–1595PubMedCrossRef

22.

Mamoulakis C, Ubbink DT, de la Rosette JJ (2009) Bipolar versus monopolar transurethral resection of the prostate: a systematic review and meta-analysis of randomized controlled trials. Eur Urol 56:798–809PubMedCrossRef

23.

Ho HS, Yip SK, Lim KB, Fook S, Foo KT, Cheng CW (2007) A prospective randomized study comparing monopolar and bipolar transurethral resection of prostate using transurethral resection in saline (TURIS) system. Eur Urol 52:517–522PubMedCrossRef

24.

Autorino R, Damiano R, Di Lorenzo G et al (2009) Four-year outcome of a prospective randomised trial comparing bipolar plasmakinetic and monopolar transurethral resection of the prostate. Eur Urol 55:922–929PubMedCrossRef

25.

Lourenco T, Armstrong N, N’Dow J et al (2008) Systematic review and economic modelling of effectiveness and cost utility of surgical treatments for men with benign prostatic enlargement. Health Technol Assess 12:1–146

26.

De Nunzio C, Ahayai S, Autorino R et al (2011) Benign prostatic hyperplasia and lower urinary tract symptoms: research priorities. Eur Urol 60(6):1205–1206PubMedCrossRef

Titel: Contemporary monopolar and bipolar transurethral resection of the prostate: prospective assessment of complications using the Clavien system
verfasst von: Cosimo De Nunzio
Riccardo Lombardo
Riccardo Autorino
Antonio Cicione
Luca Cindolo
Rocco Damiano
Marco De Sio
Mario Falsaperla
Giorgio Franco
Mauro Gacci
Costantino Leonardo
Fabrizio Presicce
Andrea Tubaro
Publikationsdatum: 01.08.2013
Verlag: Springer Netherlands
Erschienen in: International Urology and Nephrology / Ausgabe 4/2013
Print ISSN: 0301-1623
Elektronische ISSN: 1573-2584
DOI: https://doi.org/10.1007/s11255-013-0476-1

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

Battle of Experts: Sport vs. Spritze bei Adipositas und Typ-2-Diabetes

11.05.2024 DDG-Jahrestagung 2024 Kongressbericht

Im Battle of Experts traten zwei Experten auf dem Diabeteskongress gegeneinander an: Die eine vertrat die Auffassung „Sport statt Spritze“ bei Adipositas und Typ-2-Diabetes, der andere forderte „Spritze statt Sport!“ Am Ende waren sie sich aber einig: Die Kombination aus beidem erzielt die besten Ergebnisse.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Klimawandel und Gesundheit: Was Sie in der Hausarztpraxis wissen müssen und tun können

Springer Medizin

Contemporary monopolar and bipolar transurethral resection of the prostate: prospective assessment of complications using the Clavien system