title: Transvesical open prostatectomy for benign prostatic hyperplasia in the era of minimally invasive surgery: Perioperative outcomes of a contemporary series.
abstract: OBJECTIVE
  To assess the perioperative morbidity of transvesical open prostatectomy (OP) and its predictors as a treatment for benign prostatic hyperplasia (BPH), and to update knowledge about the morbidity of OP using a standardised morbidity scale (Clavien), thus providing a platform for comparison with the newly developed techniques.
  
  
  METHODS
  We retrospectively review men with BPH who were treated with transvesical OP between April 2002 and December 2012. Preoperative patients' data were reviewed for relevant variables. Operative details, the postoperative course, and 30-day relevant data were assessed. The study cohort was stratified based on the resected prostate weight, with group 1 having a resected weight of ⩽120 g and group 2 >120 g.
  
  
  RESULTS
  The review identified 163 patients. The mean (SD, range) duration of catheterisation after OP was 7.9 (2.2, 5-20) days and the duration of hospitalisation after OP was 8.1 (1.8, 5-15) days; both were significantly longer in group 2. All patients were able to void spontaneously by the first follow-up visit. Of 163 OP procedures, there were 106 perioperative complications in 69 (42.3%). Low-grade complications (grade ⩽2) included 38 (45.2%) and 53 (67%) in groups 1 and 2, respectively (P = 0.8). High-grade complications (⩾3) included 3 (3.5%) and 12 (15.1%) in groups 1 and 2, respectively (P = 0.02). The blood transfusion rate was 24.5%, the perioperative mortality rate was 1.2% and the re-admission rate within the first 30 days after OP was 1.2%. High-grade complications were significantly associated with a greater resected prostate weight (odds ratio 1.08, 95% CI 1.001-1.17, P = 0.046).
  
  
  CONCLUSIONS
  The OP procedure is associated with a significant perioperative morbidity that correlated significantly with the resected prostate weight, especially for high-grade complications.
authors.affiliation: Mansoura Urology & Nephrology Center, Mansoura University, Egypt.
authors.forename: Ahmed M
authors.initials: AM
authors.lastname: Elshal
authors.affiliation: Mansoura Urology & Nephrology Center, Mansoura University, Egypt.
authors.forename: Ahmed R
authors.initials: AR
authors.lastname: El-Nahas
authors.affiliation: Mansoura Urology & Nephrology Center, Mansoura University, Egypt.
authors.forename: Tamer S
authors.initials: TS
authors.lastname: Barakat
authors.affiliation: Mansoura Urology & Nephrology Center, Mansoura University, Egypt.
authors.forename: Mohamed M
authors.initials: MM
authors.lastname: Elsaadany
authors.affiliation: Mansoura Urology & Nephrology Center, Mansoura University, Egypt.
authors.forename: Ahmed S
authors.initials: AS
authors.lastname: El-Hefnawy
keywords: HOLEP, holmium laser enucleation of the prostate; Hyperplasia; MIS, minimally invasive surgery; OP, open prostatectomy; Outcomes; Prostate; Prostatectomy