Retrospective Analysis Of Efficacy And Incidence Of Postoperative Complications Of TUPKP At Different Surgical Timing

Objective:To investigate the effect of preoperative BPH-related comorbidities and duration of LUTS on the efficacy and complications of TUPKP.Methods:The perioperative data of hospitalized patients with BPH and LUTS symptoms from January 2014 to January 2019 in Tumor Hospital of BaoTou City and Affiliated Hospital of North Sichuan Medical College were collected and followed up by telephone.Patients who met the inclusion criteria were divided into two groups according to the presence or absence of comorbidities;patients were divided into three groups according to the duration of LUTS,with LUTS duration of 36 months and less as group 1,37-60 months as group 2,and more than 60 months as group 3.Perioperative data,postoperative outcomes and incidence of complications were compared between the comorbidity groups and amongthe LUT’S duration groups,respectively.Results:1.A total of 1395 patients were eligible for the study and 775 were successfully followed up.IPSS score(23.08±2.59 vs 6.38±3.25),QOL score(5.610.53 vs 1.22±0.87),and frequency of night urination(4.89±1.01 vs 1.85±1.16)were compared with those pre-operation and at follow-up.the differences were statistically significant(P<0.05).The total incidence of early complications was 13.55%(189/1395),and the total incidence of long-term complications was 8.52%(66/775).No Clavien grade IV or above complications occurred.2.In different LUTS duration groups,the postoperative follow-up rates were 54.1%(472/872)in group 1,58.2%(135/232)in group 2,and 57.7%(168/291)in group 3.During follow-up of IPSS score and QOL score,times of urination at night was significantly improved in group 1 compared with group 3(6.08±2.70 vs 7.18±4.37,1.14±0.78 vs 1.38±1.08,1.76±1.10 vs 2.10±1.35,respectively),and the differences were statistically significant(p<0.05).The incidence of early and long-term postoperative complications in group 1 was significantly lower than that in group 3(11.4%vs 17.5%,7.0%vs 14.3%,respectively),and the difference had statistical significance(p<0.05).3.The follow-up rate was 54.6%(456/835)in patients with comorbidities and 56.8%(318/560)in patients without comorbidities.The incidence of early complications was significantly greater in the group with comorbidities than in the group without comorbidities(15.93%vs 10.00%;p<0.05).The incidence of long-term postoperative complications was not significantly different between the two groups(p>0.05).the follow-up IPSS and QOL scores were not significantly different between the two groups(p>0.05).Conclusions:1.TUPKP issafe and effective regardless of the presence of comorbidities and the duration of LUTS.2.Patients with preoperative LUTS duration of 36 months or less has better surgical outcomes than those with LUTS duration of more than 60 months,while the risk of early and long-term complications is lower.3.The surgical outcomes of patients without comorbidities are comparable to those of patients with comorbidities,but the risk of early postoperative complications is lower.No effect of comorbidities on the risk of long-term complications is found.