title: Morbidity, mortality and early outcome of transurethral resection of the prostate: a prospective multicenter evaluation of 10,654 patients.
abstract: OBJECTIVE
  Transurethral resection of the prostate has for decades been the standard surgical therapy for lower urinary tract symptoms secondary to benign prostatic hyperplasia, the most common benign neoplasm in men. To generate a contemporary reference for evolving medical and minimally invasive therapies we analyzed complications and immediate outcomes of transurethral prostate resection in a statewide multicenter study.
  
  
  METHODS
  We prospectively evaluated 10,654 patients undergoing transurethral prostate resection in the state of Bavaria, Germany from January 1, 2002 until December 31, 2003. Case records containing 54 items concerning preoperative status, operation details, complications and immediate outcome, were recorded for each patient.
  
  
  RESULTS
  The mortality rate for transurethral prostate resection was 0.10%. The cumulative short-term morbidity rate was 11.1%. The most relevant complications were failure to void (5.8%), surgical revision (5.6%), significant urinary tract infection (3.6%), bleeding requiring transfusions (2.9%) and transurethral resection syndrome (1.4%). The resected tissue averaged 28.4 gm. Incidental carcinoma of the prostate was diagnosed by histological examination in 9.8% of patients. Urinary peak flow rate increased significantly to 21.6 +/- 9.4 ml per second (baseline 10.4 +/- 6.8 ml per second, 1 tail p <0.0001), while post-void residual decreased to 31.1 +/- 73.0 ml (baseline 180.3 +/- 296.9 ml, 1-tail p <0.0001).
  
  
  CONCLUSIONS
  In a large scale evaluation comprising 44 mostly nonacademic urological departments in Bavaria, unique real-world data for transurethral prostate resection were prospectively generated. This most contemporary information should be of use to potential patients and facilitate subsumption of emerging surgical and nonsurgical benign prostatic hyperplasia treatment options.
authors.affiliation: Department of Urology, University-Hospital Grosshadern, Ludwig-Maximilians-University Munich, Germany. oliver.reich@med.uni-muenchen.de
authors.forename: Oliver
authors.initials: O
authors.lastname: Reich
authors.forename: Christian
authors.initials: C
authors.lastname: Gratzke
authors.forename: Alexander
authors.initials: A
authors.lastname: Bachmann
authors.forename: Michael
authors.initials: M
authors.lastname: Seitz
authors.forename: Boris
authors.initials: B
authors.lastname: Schlenker
authors.forename: Peter
authors.initials: P
authors.lastname: Hermanek
authors.forename: Nicholas
authors.initials: N
authors.lastname: Lack
authors.forename: Christian G
authors.initials: CG
authors.lastname: Stief
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011470:Prostatic Hyperplasia / Q000601:surgery*; D013997:Time Factors; D020728:Transurethral Resection of Prostate / Q000009:adverse effects* / Q000401:mortality*; D016896:Treatment Outcome