Intraoperative and early postoperative complications of radical retropubic prostatectomy.
BACKGROUND
To determine the perioperative complications and morbidity of radical retropubic prostatectomy (RRP) and to analyze risk factors for observed complications.


METHODS
Data of 1,000 patients undergoing RRP and pelvic lymphadenectomy (pLA) performed by different surgeons of the same hospital were collected. Uni- and multivariate analysis was performed to detect associations between intra- and postoperative complications and specific variables.


RESULTS
Relevant intraoperative complications were observed in 28 cases and relevant postoperative complications in 187 cases requiring reoperations in 46 patients. Diverse minor postoperative complications occurred in 75 cases. The surgeon's experience and the operating time significantly influenced the incidence of intraoperative complications. Extended pLA was associated with significantly higher rates of lymphoceles and reoperations. The patients with lymphocele showed significantly higher rates of deep venous thrombosis (DVT), pulmonary embolism (PE) and reoperation and patients with DVT a higher incidence of PE and a higher rate of reoperations. The incidence of anastomotic strictures correlated significantly with postoperative urine retention.


CONCLUSIONS
RRP is a safe surgical procedure. In the hands of experienced urologic surgeons it is associated with lower incidences of severe intraoperative complications. A substantial proportion of postoperative complications are associated with pLA and its extension.
Klevecka
Virgilijus
V
Department of Urology, Kliniken Essen-Mitte, Essen, Germany.
Burmester
Luise
L
Musch
Michael
M
Roggenbuck
Ulla
U
Kroepfl
Darko
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002983:Clinical Competence; D019992:Databases as Topic; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008197:Lymph Node Excision / Q000009:adverse effects* / Q000706:statistics & numerical data; D008210:Lymphocele / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000009:adverse effects* / Q000706:statistics & numerical data; D011471:Prostatic Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D011655:Pulmonary Embolism / Q000453:epidemiology / Q000209:etiology*; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014525:Urethral Stricture / Q000150:complications / Q000453:epidemiology / Q000209:etiology*; D016055:Urinary Retention / Q000453:epidemiology / Q000209:etiology*; D020246:Venous Thrombosis / Q000453:epidemiology / Q000209:etiology*