Intraoperative urological complications in transurethral surgical interventions on the prostate for benign hyperplasia

Wide clinical introduction of endoscopic methods in management of lower urinary tract (LUT) diseases is explained both by their high efficacy and relative safety. In spite of perfection of endourological tools, no large-scale clinical trials have been performed of late analyzing the rate of complications of endoscopic treatment of benign prostatic hyperplasia (BPH). A total of 5401 transurethral endoscopic operations were made in BPH patients. The spectrum of endoscopic operations made in the Research Institute of Urology (1991-2003) and Krasnodar Regional Hospital N 1 (1998-2003) covered the following operations: transurethral prostatic resection (5003-92.6%), transurethral prostatic incision (112-2.1%), transurethral rolling electrovaporisation of the prostate (119-2.2%), transurethral vaporizing resection of the prostate (107-1.98%), transurethral rotoresection of the prostate (60-1.1%). Overall number of intraoperative complications was 191 or 3.5%. Most frequent complications were closed and open perforation of the prostatic capsule (1.6 and 0.4%, respectively), a mechanical trauma of the prostate and urethra (0.3 and 0.15%, respectively), development of the syndrome of water intoxication (0.13%), intraoperative blood loss compensated by hemotransfusion (0.5%). Rare complications comprised injury of the ureteral ostia (0.09%), rupture of the urinary bladder (0.02%). Thus, transurethral endoscopic surgery is characterized by high safety, a trend to lowering of the number of intraoperative complications in transurethral endoscopic operations. Adherence to specification and TUR techniques leads to minimization of serious complications number.