TURP Outcomes and Survival in Men Aged 85 and Older with BPO

Overview

This retrospective cohort study evaluated transurethral resection of the prostate (TURP) in men aged 85 years and older, focusing on safety, effectiveness, complications, and one-year survival. The study included 194 procedures with a median follow-up of 6 years, revealing acceptable complication rates and significant catheter-free status postoperatively.

Background

Benign prostatic obstruction (BPO) commonly affects older men, causing lower urinary tract symptoms, acute urinary retention, and often necessitating long-term catheterization. As life expectancy increases, more men aged 85 and older present with symptomatic BPO, posing challenges due to frailty and comorbidities. TURP remains the standard surgical treatment, but data on outcomes in this extreme elderly population are limited. Understanding surgical risks and benefits in this group is critical to balancing treatment decisions against the morbidity of conservative management.

Data Highlights

Key Findings

• TURP in men aged ≥85 showed acceptable safety with postoperative complications classified by Clavien–Dindo within 30 days.
• 62% of patients were catheter dependent preoperatively; catheter-free status at 3 months was used as a measure of treatment success.
• Frailty, inferred from formal care dependency, was present in 28% and is an important consideration for surgical risk.
• 66% of patients were on anticoagulant or antiplatelet therapy, managed perioperatively according to national guidelines.
• One-year survival was assessed and compared to age-matched Norwegian population data, providing context for expected outcomes.

Clinical Implications

TURP can be considered a viable surgical option for men aged 85 and older with symptomatic BPO, including those with significant comorbidities and anticoagulant use, when carefully managed. Preoperative assessment of frailty and comorbidity is essential to optimize outcomes and anticipate complications. Surgical intervention may reduce catheter dependence and improve quality of life compared to conservative management.

Conclusion

This study supports the safety and effectiveness of TURP in the extreme elderly population, demonstrating acceptable complication rates and meaningful postoperative improvements. These findings aid clinicians in balancing surgical risks against the morbidity of untreated BPO in men aged 85 and older.

References

1. Regional Committee for Medical and Health Research Ethics (REK-no: 739374) -- Ethical Approval and Study Conduct
2. National guidelines on perioperative antithrombotic management -- Reference [13]
3. Norwegian population mortality data -- Reference [14]