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Impact of kidney disease on perioperative outcomes of endoscopic BPH surgery: a propensity score matched analysis from the NSQIP database

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Abstract

Introduction

To assess the impact of kidney function in patients with BPH undergoing surgery prior to Transurethral resection of prostate (TURP), Laser enucleation of the prostate (LEP), and Laser Vaporization of the prostate (LVP) on operative and post-operative outcomes using the ACS-NSQIP database.

Methods

The ACS-NSQIP database was reviewed for patients that underwent TURP, LEP and LVP for treatment of patients with BPH between the years of 2008 and 2021. Demographics, comorbidities, bleeding disorders, operative time, and surgical procedure performed were collected for comparison between Kidney function groups: G1, normal/high function; G2-G3, mild/moderate kidney disease; and G4-G5, severe kidney disease. The 30-day peri-operative complications were measured and a multivariate logistic regression analysis was performed while adjusting for all confounding variables. Propensity score matching was performed between the G1 and G4-G5 cohorts.

Results

A total of 83,020 patients were included. On multivariable regression, in the G2-G3 cohort, patients were at significantly increased risk for renal complications with OR = 2.43[1.56–3.79]. After propensity score matching, the G4-G5 cohort showed increased odds of pneumonia OR = 4.02[1.343–12.056], renal complications with OR = 7.62[2.283–25.411], cardiac complications OR = 4.53[1.531–13.411], and sepsis/septic shock OR = 1.76[1.091–2.834]. They also had a higher need for blood transfusion OR = 3.58[2.242–5.714], and prolonged hospital stay with OR = 1.49[1.296–1.723].

Conclusion

Pre-operative kidney disease may pose an increased risk of complications for patients undergoing endoscopic BPH surgery. The literature lacks information on the effect of pre-operative kidney disease on endoscopic BPH surgeries. Further studies are required to compare post-operative outcomes of LEP and LVP as compared to TURP across kidney function status.

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Availability of data and materials

ACS-NSQIP data is a national database that can be provided upon request if needed.

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Funding

This study did not receive any funding or grant from any source.

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Author notes

  1. Oussama G. Nasrallah and Maya T. Herrera have contributed equally to this work.

Authors and Affiliations

  1. Division of Urology, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon

    Oussama G. Nasrallah, Maya T. Herrera, Nassib F. Abou Heidar & Rami W. Nasr

  2. Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon

    Jana H. Mahdi

Authors
  1. Oussama G. Nasrallah
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  2. Maya T. Herrera
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  3. Nassib F. Abou Heidar
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  4. Jana H. Mahdi
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  5. Rami W. Nasr
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Contributions

Article design: Rami W. Nasr, Oussama G. Nasrallah, Maya T. Herrera. Drafting of manuscript: Oussama G. Nasrallah, Maya T. Herrera, Jana H. Mahdi. Data analysis: Maya T. Herrera. Critical revision of the manuscript: Rami W. Nasr, Nassib F. Abou Heidar. All authors read and approved the final manuscript.

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Correspondence to Rami W. Nasr.

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Nasrallah, O.G., Herrera, M.T., Heidar, N.F.A. et al. Impact of kidney disease on perioperative outcomes of endoscopic BPH surgery: a propensity score matched analysis from the NSQIP database. World J Urol 42, 337 (2024). https://doi.org/10.1007/s00345-024-05039-5

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  • DOI: https://doi.org/10.1007/s00345-024-05039-5

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