title: The modified Clavien classification system: a standardized platform for reporting complications in transurethral resection of the prostate.
abstract: OBJECTIVE
  The aim of the study was to evaluate the applicability of the modified Clavien classification system (CCS) in grading perioperative complications of transurethral resection of the prostate (TURP).
  
  
  METHODS
  All patients with benign prostatic hyperplasia submitted to monopolar TURP from January 2006 to February 2008 at a non-academic center were evaluated for complications occurring up to the end of the first postoperative month. All complications were classified according to the modified CCS independently by two urologists, and the final decision was based on consensus. If multiple complications per patient occurred, categorization was done in more than one grade. Results were presented as complication rates per grade.
  
  
  RESULTS
  Forty-four complications were recorded in 31 out of 198 patients (overall perioperative morbidity rate: 15.7%), and their grading was generally easy, non-time-consuming and straightforward. Most of them were classified as grade I (59.1%) and II (29.5%). Higher grade complications were scarce (grade III: 2.3% and grade IV: 6.8%, respectively) There was one death (grade V: 2.3%) due to acute myocardial infarction (overall mortality rate: 0.5%). Negative outcomes such as mild dysuria during this early postoperative period or retrograde ejaculation were considered sequelae and were not recorded. Nobody was complicated with severe dysuria. There was one re-operation due to residual adenoma (0.5%).
  
  
  CONCLUSIONS
  The modified CCS represents a straightforward and easily applicable tool that may help urologists to classify the complications of TURP in a more objective and detailed way. It may serve as a standardized platform of communication among clinicians allowing for sound comparisons.
authors.affiliation: Department of Urology, University of Crete, Heraklion, Greece. c.mamoulakis@amc.uva.nl
authors.forename: Charalampos
authors.initials: C
authors.lastname: Mamoulakis
authors.forename: Ioannis
authors.initials: I
authors.lastname: Efthimiou
authors.forename: Savas
authors.initials: S
authors.lastname: Kazoulis
authors.forename: Ioannis
authors.initials: I
authors.lastname: Christoulakis
authors.forename: Frank
authors.initials: F
authors.lastname: Sofras
mesh_terms: D000368:Aged; D006115:Greece; D006417:Hematuria / Q000145:classification / Q000209:etiology; D006801:Humans; D007431:Intraoperative Complications / Q000145:classification* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000145:classification / Q000209:etiology; D011467:Prostate / Q000601:surgery*; D011470:Prostatic Hyperplasia / Q000601:surgery*; D011655:Pulmonary Embolism / Q000145:classification / Q000209:etiology; D012189:Retrospective Studies; D020728:Transurethral Resection of Prostate / Q000009:adverse effects* / Q000379:methods; D014552:Urinary Tract Infections / Q000145:classification / Q000209:etiology
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