Can a Simple Geriatric Assessment Predict the Outcome of TURP?

Abstract

PURPOSE:

To determine the impact of a simple preoperative geriatric assessment on the outcome in older patients with recurrent urinary retention who underwent desobstructive surgery.

PATIENTS AND METHODS:

Patients aged 75 years or older with recurrent urinary retention referred for TURP entered this prospective, multicentre study. Several demographic, intra- and postoperative parameters were assessed. Preoperative geriatric assessment was performed by the 7-item Canadian Study of Health and Ageing (CSHA) frailty scale (1: very fit, 7: severely frail; completion takes less than a minute). The main outcome parameters were successful voiding rates at discharge and 3 months postoperatively.

RESULTS:

A total of 54 patients were recruited; 42 (77.8%) patients had a CSHA index of 1-3 and were considered as "fit", the remaining 12 (22.2%) formed the "frail" group (CSHA index 4-7). Age was identical in both cohorts (79.5 ± 3.7 vs. 79.7 ± 3.3 years); differences were demonstrable for the American Society of Anesthesiologists (ASA) score (p = 0.001), the number of daily medications (>4: 32 vs. 75%, p = 0.02), falls within the past 6 months (12 vs. 33%), and the necessity of home/nursing care (5 vs. 42%, p = 0.004). Intra- and perioperative complications, duration of postoperative catheterization, and length of hospitalization were identical in both cohorts. The success rate at discharge was 80.6% in fit and 75.0% in frail patients; the respective values at 3 months were 95.2 and 83.3%.

CONCLUSIONS:

A simple 1-min geriatric assessment tool can predict - to a certain extent - the outcome of desobstructive surgery in older patients with recurrent urinary retention. Fit patients achieve an excellent outcome while frail patients might benefit from a more in-depth urodynamic/geriatric evaluation.

• Authors: Klaus Eredics, Christine Meyer, Tanja Gschliesser, Branimir Lodeta, Ortwin Heissler, Thomas Kunit, Stephan Madersbacher
• Journal: Urologia internationalis (Urol Int) Vol. 104 Issue 5-6 Pg. 367-372 ( 2020) ISSN: 1423-0399 [Electronic] Switzerland
• PMID: 32235127 (Publication Type: Journal Article)
• Copyright: © 2020 S. Karger AG, Basel.

Topics

• Aged
• Aged, 80 and over
• Geriatric Assessment
• Humans
• Male
• Predictive Value of Tests
• Prospective Studies
• Prostatic Hyperplasia (complications, diagnosis, surgery)
• Recurrence
• Transurethral Resection of Prostate
• Treatment Outcome
• Urinary Retention (etiology, surgery)