Skip to main content
Top
Published in: International Urology and Nephrology 2/2013

01-04-2013 | Urology-Original Paper

Grading complications after transurethral resection of prostate using modified Clavien classification system and predicting complications using the Charlson comorbidity index

Authors: Swarnendu Mandal, Satya N. Sankhwar, Rohit Kathpalia, Manish Kumar Singh, Manoj Kumar, Apul Goel, Vishwajeet Singh, Rahul Janak Sinha, Bhupender Pal Singh, Divakar Dalela

Published in: International Urology and Nephrology | Issue 2/2013

Login to get access

Abstract

Purpose

To retrospectively report and grade the peri-operative complications of transurethral resection of the prostate (TURP) using the modified Clavien classification system (MCCS) and validate whether Charlson comorbidity index (CCI) predicts the complications after TURP.

Materials and methods

Between September 2006 and 2012, data of 722 patients who underwent TURP were analyzed after excluding patients with incomplete data (n = 40). Data recorded included the age, prostate volume, operative time, mean prostatic tissue removed and duration of hospitalization while complications were recorded using the MCCS. Preexisting comorbidities were evaluated using the CCI, and patients were classified into 3 CCI score categories (0, 1, ≥2).

Results

Two hundred and forty-four complications were seen in 145 (20 %) patients. CCI score was “0” for 480 patients (66.5 %), “1” for 184 patients (25.5 %) and “≥2” for 58 patients (8 %). Significant difference was observed between patient groups with CCI score 0, 1 and ≥2 for mean age, prostatic weight, operative time, weight of prostatic chips and duration of hospitalization. Similarly, a significant difference in occurrence of various MCCS grades of complication among patients groups with different CCI score was observed.

Conclusion

Grades I, II and III complications constituted the main bulk (90 %) while grade IV were less common (<8 %) and grade V was rare (1 %) after TURP. Men with higher CCI score had a significantly higher rate of morbidity than those with a lower score. The present study is the first to validate that CCI can predict complications of TURP recorded according to the MCCS.
Literature
1.
go back to reference Reich O, Gratzke C, Bachmann A et al (2008) Morbidity, mortality and early outcome of transurethral resection of the prostate: a prospective multicenter evaluation of 10,654 patients. J Urol 180:246–249PubMedCrossRef Reich O, Gratzke C, Bachmann A et al (2008) Morbidity, mortality and early outcome of transurethral resection of the prostate: a prospective multicenter evaluation of 10,654 patients. J Urol 180:246–249PubMedCrossRef
2.
go back to reference Lukacs B, Loeffler J, Bruyère F et al (2012) Photoselective vaporization of the prostate with Greenlight 120-W laser compared with monopolar transurethral resection of the prostate: a multicenter randomized controlled trial. Eur Urol 61(6):1165–1173PubMedCrossRef Lukacs B, Loeffler J, Bruyère F et al (2012) Photoselective vaporization of the prostate with Greenlight 120-W laser compared with monopolar transurethral resection of the prostate: a multicenter randomized controlled trial. Eur Urol 61(6):1165–1173PubMedCrossRef
3.
go back to reference Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of a 6,336 patients and results of a survey. Ann Surg 240:205–213PubMedCrossRef Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of a 6,336 patients and results of a survey. Ann Surg 240:205–213PubMedCrossRef
4.
go back to reference Rabbani F, Yunis HL, Pinochet R (2010) Comprehensive standardized report of complications of retropubic and laparoscopic radical prostatectomy. Eur Urol 57:371–386PubMedCrossRef Rabbani F, Yunis HL, Pinochet R (2010) Comprehensive standardized report of complications of retropubic and laparoscopic radical prostatectomy. Eur Urol 57:371–386PubMedCrossRef
5.
go back to reference Ramasamy R, Afaneh C, Katz M et al (2011) Comparison of complications of laparoscopic versus laparo-endoscopic single site donor nephrectomy using the modified Clavien grading system. J Urol 186:1386–1390PubMedCrossRef Ramasamy R, Afaneh C, Katz M et al (2011) Comparison of complications of laparoscopic versus laparo-endoscopic single site donor nephrectomy using the modified Clavien grading system. J Urol 186:1386–1390PubMedCrossRef
6.
go back to reference Szydełko T, Kasprzak J, Apoznan′ski W et al (2011) Clavien classification of complications after 150 laparoscopic pyeloplasties. Urology 77:1359–1364PubMedCrossRef Szydełko T, Kasprzak J, Apoznan′ski W et al (2011) Clavien classification of complications after 150 laparoscopic pyeloplasties. Urology 77:1359–1364PubMedCrossRef
7.
go back to reference Ramasamy R, Afaneh C, Katz M et al (2011) Comparison of complications of laparoscopic versus laparoendoscopic single site donor nephrectomy using the modified Clavien grading system. J Urol 186(4):1386–1390PubMedCrossRef Ramasamy R, Afaneh C, Katz M et al (2011) Comparison of complications of laparoscopic versus laparoendoscopic single site donor nephrectomy using the modified Clavien grading system. J Urol 186(4):1386–1390PubMedCrossRef
8.
go back to reference Mamoulakis C, Efthimiou I, Kazoulis S et al (2011) The modified Clavien classification system: a standardized platform for reporting complications in transurethral resection of the prostate. World J Urol 29:205–210PubMedCrossRef Mamoulakis C, Efthimiou I, Kazoulis S et al (2011) The modified Clavien classification system: a standardized platform for reporting complications in transurethral resection of the prostate. World J Urol 29:205–210PubMedCrossRef
9.
go back to reference Mandal S, Goel A, Kathpalia R et al (2012) Prospective evaluation of complications using the modified Clavien grading system and success rates of percutaneous nephrolithotomy using guy’s stone score: a single center experience. Indian J Urol 28(4):392–398PubMedCrossRef Mandal S, Goel A, Kathpalia R et al (2012) Prospective evaluation of complications using the modified Clavien grading system and success rates of percutaneous nephrolithotomy using guy’s stone score: a single center experience. Indian J Urol 28(4):392–398PubMedCrossRef
10.
go back to reference Mandal S, Goel A, Singh MK et al (2012) Clavien classification of semirigid ureteroscopy complications. A prospective study. Urology 80(5):995–1001PubMedCrossRef Mandal S, Goel A, Singh MK et al (2012) Clavien classification of semirigid ureteroscopy complications. A prospective study. Urology 80(5):995–1001PubMedCrossRef
11.
go back to reference Charlson ME, Pompei P, Ales KL et al (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40:373–383PubMedCrossRef Charlson ME, Pompei P, Ales KL et al (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40:373–383PubMedCrossRef
12.
go back to reference Guzzo TJ, Dluzniewski P, Orosco R et al (2010) Prediction of mortality after radical prostatectomy by Charlson comorbidity index. Urology 76:553–557PubMedCrossRef Guzzo TJ, Dluzniewski P, Orosco R et al (2010) Prediction of mortality after radical prostatectomy by Charlson comorbidity index. Urology 76:553–557PubMedCrossRef
13.
go back to reference O’Connor KM, Davis N, Lennon GM et al (2009) Can we avoid surgery in elderly patients with renal masses by using the Charlson comorbidity index? BJU Int 103:1492–1495PubMedCrossRef O’Connor KM, Davis N, Lennon GM et al (2009) Can we avoid surgery in elderly patients with renal masses by using the Charlson comorbidity index? BJU Int 103:1492–1495PubMedCrossRef
14.
go back to reference Unsal A, Resorlu B, Atmaca AF, AkifDiri A, Goktug HNG, Can CE et al (2012) Prediction of morbidity and mortality after percutaneous nephrolithotomy by using the Charlson comorbidity index. Urology 79(1):55–60PubMedCrossRef Unsal A, Resorlu B, Atmaca AF, AkifDiri A, Goktug HNG, Can CE et al (2012) Prediction of morbidity and mortality after percutaneous nephrolithotomy by using the Charlson comorbidity index. Urology 79(1):55–60PubMedCrossRef
15.
go back to reference Resorlu B, Diri A, Atmaca AF et al (2012) Can we avoid percutaneous nephrolithotomy in high-risk elderly patients using the Charlson comorbidity index? Urology 79(5):1042–1047PubMedCrossRef Resorlu B, Diri A, Atmaca AF et al (2012) Can we avoid percutaneous nephrolithotomy in high-risk elderly patients using the Charlson comorbidity index? Urology 79(5):1042–1047PubMedCrossRef
16.
go back to reference Rassweiler J, Teber D, Kuntz R et al (2006) Complications of transurethral resection of the prostate (TURP)—incidence, management, and prevention. Eur Urol 50:969–979PubMedCrossRef Rassweiler J, Teber D, Kuntz R et al (2006) Complications of transurethral resection of the prostate (TURP)—incidence, management, and prevention. Eur Urol 50:969–979PubMedCrossRef
17.
go back to reference Furuya S, Furuya R, Ogura H et al (2006) A study of 4,031 patients of transurethral resection of the prostate performed by one surgeon: learning curve, surgical results and postoperative complications. Hinyokika Kiyo 52(8):609–614PubMed Furuya S, Furuya R, Ogura H et al (2006) A study of 4,031 patients of transurethral resection of the prostate performed by one surgeon: learning curve, surgical results and postoperative complications. Hinyokika Kiyo 52(8):609–614PubMed
18.
go back to reference Xiong W, Sun M, Ran Q et al. (2012) Learning curve for bipolar Transurethral enucleation and resection of the prostate in saline for symptomatic benign prostatic hyperplasia: experience in the first 100 consecutive patients. Urol Int. [Epub ahead of print] Xiong W, Sun M, Ran Q et al. (2012) Learning curve for bipolar Transurethral enucleation and resection of the prostate in saline for symptomatic benign prostatic hyperplasia: experience in the first 100 consecutive patients. Urol Int. [Epub ahead of print]
19.
go back to reference Fitzpatrick JM (2007) Minimally invasive and endoscopic management of benign prostatic hyperplasia. In: Kavoussi LR, Partin AW, Novick AC (eds) Campbell-walsh urology, 9th edn. Saunders, Philadelphia, p 2832 Fitzpatrick JM (2007) Minimally invasive and endoscopic management of benign prostatic hyperplasia. In: Kavoussi LR, Partin AW, Novick AC (eds) Campbell-walsh urology, 9th edn. Saunders, Philadelphia, p 2832
20.
go back to reference Hong JY, Yang SC, Ahn S et al (2011) Preoperative comorbidities and relationship of comorbidities with postoperative complications in patients undergoing transurethral prostate resection. J Urol 185:1378–1384 Hong JY, Yang SC, Ahn S et al (2011) Preoperative comorbidities and relationship of comorbidities with postoperative complications in patients undergoing transurethral prostate resection. J Urol 185:1378–1384
21.
go back to reference Djavan B, Madersbacher S, Klingler C et al (1997) Urodynamic assessment of patients with acute urinary retention: is treatment failure after prostectomy predictable? J Urol 158:1829–1833PubMedCrossRef Djavan B, Madersbacher S, Klingler C et al (1997) Urodynamic assessment of patients with acute urinary retention: is treatment failure after prostectomy predictable? J Urol 158:1829–1833PubMedCrossRef
22.
go back to reference Kuntz RM, Ahyai S, Lehrich K et al (2004) Transurethral holmium laser enucleation of the prostate versus transurethral electrocautery resection of the prostate: a randomized prospective trial in 200 patients. J Urol 172:1012–1016PubMedCrossRef Kuntz RM, Ahyai S, Lehrich K et al (2004) Transurethral holmium laser enucleation of the prostate versus transurethral electrocautery resection of the prostate: a randomized prospective trial in 200 patients. J Urol 172:1012–1016PubMedCrossRef
23.
go back to reference Colau A, Lucet JC, Rufat P et al (2001) Incidence and risk factors of bacturia after transurethral resection of the prostate. Eur Urol 39(3):272–276PubMedCrossRef Colau A, Lucet JC, Rufat P et al (2001) Incidence and risk factors of bacturia after transurethral resection of the prostate. Eur Urol 39(3):272–276PubMedCrossRef
24.
go back to reference Holtgrewe HL, Valk WL (1962) Factors influencing the mortality and morbidity of transurethral prostatectomy: a study of 2,015 cases. J Urol 87:450–459PubMed Holtgrewe HL, Valk WL (1962) Factors influencing the mortality and morbidity of transurethral prostatectomy: a study of 2,015 cases. J Urol 87:450–459PubMed
25.
go back to reference Madersbacher S, Lackner J, Brössner C et al (2005) Prostate study group of the austrian society of urology. Reoperation, myocardial infarction and mortality after transurethral and open prostatectomy: a nation-wide, long-term analysis of 23,123 cases. Eur Urol 47:499–504PubMedCrossRef Madersbacher S, Lackner J, Brössner C et al (2005) Prostate study group of the austrian society of urology. Reoperation, myocardial infarction and mortality after transurethral and open prostatectomy: a nation-wide, long-term analysis of 23,123 cases. Eur Urol 47:499–504PubMedCrossRef
26.
go back to reference Madersbacher S, Marberger M (1999) Is transurethral resection of the prostate still justified? BJU Int 83:227–237PubMedCrossRef Madersbacher S, Marberger M (1999) Is transurethral resection of the prostate still justified? BJU Int 83:227–237PubMedCrossRef
27.
go back to reference Morgan M, Smith NS, Thomas K et al (2009) Is Clavien the new standard for reporting urological complications? BJU Int 104:434–436PubMedCrossRef Morgan M, Smith NS, Thomas K et al (2009) Is Clavien the new standard for reporting urological complications? BJU Int 104:434–436PubMedCrossRef
28.
go back to reference Graefen M (2010) The modified Clavien system: a plea for a standardized reporting system for surgical complications. Eur Urol 57:387–389PubMedCrossRef Graefen M (2010) The modified Clavien system: a plea for a standardized reporting system for surgical complications. Eur Urol 57:387–389PubMedCrossRef
Metadata
Title
Grading complications after transurethral resection of prostate using modified Clavien classification system and predicting complications using the Charlson comorbidity index
Authors
Swarnendu Mandal
Satya N. Sankhwar
Rohit Kathpalia
Manish Kumar Singh
Manoj Kumar
Apul Goel
Vishwajeet Singh
Rahul Janak Sinha
Bhupender Pal Singh
Divakar Dalela
Publication date
01-04-2013
Publisher
Springer Netherlands
Published in
International Urology and Nephrology / Issue 2/2013
Print ISSN: 0301-1623
Electronic ISSN: 1573-2584
DOI
https://doi.org/10.1007/s11255-013-0399-x

Other articles of this Issue 2/2013

International Urology and Nephrology 2/2013 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.