title: Standard surgical treatment for benign prostatic hyperplasia is safe for patients over 75 years: analysis of 100 cases from a high-volume urologic center.
abstract: OBJECTIVE
  In this study, we aimed to determine the complications of standard surgical treatments among patients over 75 years in a high-volume urologic center.
  
  
  METHODS
  We analyzed 100 consecutive patients older than 75 years who had undergone transurethral prostatic resection of the prostate or open prostatectomy for treatment of benign prostatic hyperplasia from January 2008 to March 2010. We analyzed patient age, prostate volume, prostate-specific antigen level, international prostatic symptom score, quality of life score, urinary retention, co-morbidities, surgical technique and satisfaction with treatment.
  
  
  RESULTS
  Median age was 79 years. Forty-eight patients had undergone transurethral prostatic resection of the prostate, and 52 had undergone open prostatectomy. The median International Prostatic Symptom Score was 20, the median prostate volume was 83 g, 51% were using an indwelling bladder catheter, and the median prostate-specific antigen level was 5.0 ng/ml. The most common comorbidities were hypertension, diabetes and coronary disease. After a median follow-up period of 17 months, most patients were satisfied. Complications were present in 20% of cases. The most common urological complication was urethral stenosis, followed by bladder neck sclerosis, urinary fistula, late macroscopic hematuria and persistent urinary incontinence. The most common clinical complication was myocardial infarction, followed by acute renal failure requiring dialysis. Incidental carcinoma of the prostate was present in 6% of cases. One case had urothelial bladder cancer.
  
  
  CONCLUSIONS
  Standard surgical treatments for benign prostatic hyperplasia are safe and satisfactory among the elderly. Complications are infrequent, and urethral stenosis is the most common. No clinical variable is associated with the occurrence of complications.
authors.affiliation: Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Division of Urology, São Paulo/SP, Brazil.
authors.forename: Rafael
authors.initials: R
authors.lastname: Marmiroli
authors.forename: Alberto A
authors.initials: AA
authors.lastname: Antunes
authors.forename: Sabrina T
authors.initials: ST
authors.lastname: Reis
authors.forename: Elcio
authors.initials: E
authors.lastname: Nakano
authors.forename: Miguel
authors.initials: M
authors.lastname: Srougi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D003327:Coronary Disease / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D009203:Myocardial Infarction / Q000453:epidemiology / Q000209:etiology*; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy / Q000009:adverse effects* / Q000379:methods; D011470:Prostatic Hyperplasia / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D020728:Transurethral Resection of Prostate / Q000009:adverse effects* / Q000379:methods; D016896:Treatment Outcome; D014525:Urethral Stricture / Q000453:epidemiology / Q000209:etiology*
chemical_list: D017430:Prostate-Specific Antigen