title: Functional Outcomes After Transurethral Resection of the Prostate in Nursing Home Residents.
abstract: OBJECTIVE
  To understand outcomes of transurethral resection of the prostate (TURP) or transurethral laser incision of the prostate (TULIP) for the treatment of bladder outlet obstruction in men with high levels of functional dependence, which are poorly understood.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  U.S. nursing homes (NHs).
  
  
  METHODS
  Male NH residents aged 65 and older who underwent TURP or TULIP in the United States between 2005 and 2008 (N = 2,869).
  
  
  METHODS
  Changes in activities of daily living (ADLs), Foley catheter status, and survival up to 12 months after surgery were examined. Multivariate regression was used to determine risk of having a Foley catheter 1 year after surgery.
  
  
  RESULTS
  Sixty-one percent of the cohort had a Foley catheter before the procedure. Of men with a Foley catheter at baseline, 64% had a Foley catheter, 4% had no Foley catheter, and 32% had died by 1-year after the procedure. Having a Foley catheter at baseline (risk ratio (RR) = 1.39, 95% confidence interval (CI) = 1.29-1.50) and poor baseline functional status (RR = 1.34, 95% CI = 1.18-1.52 for individuals in the worst quartile of function) were associated with greater risk of having a Foley catheter at 1-year.
  
  
  CONCLUSIONS
  Poor baseline functional status and having a Foley catheter preoperatively were associated with greater risk of TURP or TULIP failure, as measured by the presence of a Foley catheter at 1 year. Preoperative measurement of ADLs may aid in surgical decision-making in this population.
authors.affiliation: Department of Urology, University of California San Francisco, San Francisco, California.
authors.forename: Anne M
authors.initials: AM
authors.lastname: Suskind
authors.affiliation: Division of Geriatrics, Veterans Affairs Medical Center, San Francisco, California.|Division of Geriatrics, Department of Medicine, University of California San Francisco, San Francisco, California.
authors.forename: Louise C
authors.initials: LC
authors.lastname: Walter
authors.affiliation: Department of Urology, University of California San Francisco, San Francisco, California.
authors.forename: Shoujun
authors.initials: S
authors.lastname: Zhao
authors.affiliation: Department of Surgery, University of California San Francisco, San Francisco, California.
authors.forename: Emily
authors.initials: E
authors.lastname: Finlayson
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D006801:Humans; D008297:Male; D009735:Nursing Homes; D020127:Recovery of Function; D012189:Retrospective Studies; D015996:Survival Rate; D020728:Transurethral Resection of Prostate; D016896:Treatment Outcome; D014481:United States; D014546:Urinary Catheterization / Q000706:statistics & numerical data*
keywords: Foley catheter; Medicare; frail; geriatric; urology