Presented by: Ahmad Alam MBBS, MS
John Hunter Hospital, Newcastle, Australia

Introduction

Benign prostatic hyperplasia (BPH)is a common condition causing lower urinary tract symptoms in Australian men. BPH accounts for 228,000 general practice visits per year. The purpose of this retrospective chart review study was to investigate the major reasons for readmission of patients who underwent Transurethral resection of the prostate (TURP) surgery in an Australian Centre.

 

 

Materials

Data from 311 patients who underwent TURP for Benign Prostatic Hyperplasia from January 2019 to September 2020 were retrospectively analysed. Demographic information, patient factors, and intra-hospitalization characteristics were collected from online data records, including age, anticoagulant or antiplatelet therapy, preoperative catheterization, American Society of Anaesthesiologists (ASA) score, and preoperative urine culture. Perioperative factors, such as length of stay and days to readmission since the procedure, were also collected. Two patients were excluded from the analysis; one was readmitted for non-urological reasons (social reasons) two weeks after the procedure, and the other was excluded due to a lack of data.  

Results

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Of the 309 patients included in the analysis, 35 were readmitted within 30 days of discharge.  The readmission rates for 2019 and 2020 were 13.17% (26 out of 205 surgeries) and 9.43% (9 out of 106 surgeries), respectively. The major reasons for readmission were clot retention from haematuria (40.6%), urinary retention (21.8%), infection (15.6%) and catheter complications (15.6%). The overall 30-day ward readmission rate was 11.2%, which is consistent with previous studies reporting readmission rates ranging from 4.24% to 14.4%. Factors associated with readmission in our study included higher ASA score (infection), preoperative catheterization (infection), and the presence of antiplatelet/anticoagulants (clot retention).

Conclusion

The study recommends implementing a standardized protocol for preoperative optimisation of TURP patients. To further advance in the field, upcoming research should prioritize the creation of comprehensive guidelines for discontinuing and administering antiplatelet or anticoagulant medications. Additionally, there is a need for research into better patient selection based on their ASA scores.

Funding

This study was unfunded.