Transurethral prostate resection for urinary retention: does age affect outcome?

BACKGROUND: Patients presenting in urinary retention secondary to prostatic obstruction are offered transurethral resection of the prostate (TURP) to free them from long-term catheterization. Short-term success is well understood, but there is scarce data about effect of age on outcome, quality of life and catheter-free rates. METHODS: One hundred consecutive patients who presented in urinary retention and underwent TURP were identified. Patients were followed up for 3 years to establish the rate of catheter dependence, incontinence, pad usage and quality of life using the International Prostate Symptom Score. RESULTS: Data were obtained from 95 patients with mean age of 75.6 years and mean follow-up of 704 days. A total of 14 had died and 23 had prostate cancer. Eighty-seven per cent was passing urine and 13% was catheter dependent. Mean age of catheter-dependent patients was 84.9 years compared with 74.3 years in catheter-free men (P < 0.0001). Twenty-four per cent of patients 80 years and older were catheter dependent (P = 0.0039), 22% with prostate cancer were catheter dependent (P = 0.15). Fifty per cent of those who had died were catheter dependent (P = 0.0002). Thirty-one per cent of patients reported leakage of urine but only 5% reported leakage requiring pad use. Overall, the mean quality of life score was 1.08. CONCLUSION: Outcome after TURP for urinary retention is satisfactory. Advanced age is associated with higher long-term failure requiring catheterization, although it is still recommended in the elderly where an anaesthetic is safe. A high proportion of patients report urine leakage but the majority of this is clinically insignificant. Overall, patients report good quality of life.