Assessment of Complications of Transurethral Resection of Prostate (TURP) Using Clavien Dindo Classification

Authors

  • Bashir Ahmed Author
  • Arif Ali Author
  • Ayesha Khan Author
  • Naresh Kumar Valecha Author
  • Abdul Mujeeb Author
  • Shahid Hussain Author

DOI:

https://doi.org/10.51985/JBUMDC2025784

Keywords:

Prostatic hyperplasia, Transurethral resection of prostate, Postoperative complications, Clavien-Dindo classification

Abstract

 Objective: To evaluate the magnitude of complications that manifest in patients undergoing Transurethral Resection of
the Prostate (TURP), the Clavien-Dindo Classification System (ranging from Grades I to V) shall be employed.
Methodology: This cross-sectional investigation was performed within the Department of Urology at the Jinnah Postgraduate
Medical Center (JPMC) located in Karachi. The selection criteria included male patients aged between 40 and 65 years
presenting with benign prostatic hyperplasia and who were deemed eligible for Transurethral Resection of the Prostate.
Postoperatively, patients were treated and followed closely for any TURP related complications by classifying them
according to the Clavien-Dindo Classification System (Grade I–V). The data were analyzed using SPSS software, version
26, with 5% level of significance.
Results: In 87 male patients, the mean age was 59.32 ± 6.44 years. Complications occurred in 33.33% of cases. Grade I
complications were most frequent (48.3%), followed by Grade II (24.1%) and Grade III (13.8%), with Grade IV and V
each at 3.4%. No significant association was found with age, prostate volume, or operative time (P >0.05).
Conclusion: The investigation elucidates that Transurethral Resection of the Prostate (TURP) continues to be a procedure
characterized by a generally favorable safety profile and efficacy, albeit accompanied by the potential for complications.
The implementation of the Clavien-Dindo classification system facilitated a methodical evaluation of postoperative morbidity.
These results underscore the imperative for diligent perioperative management and the adoption of standardized protocols
for complication assessment to enhance patient care and surgical results within the domain of clinical urology 

References

1. Ye Z, Wang J, Xiao Y, Luo J, Xu L, Chen Z. Global burden

of benign prostatic hyperplasia in males aged 60–90 years

from 1990 to 2019: results from the global burden of disease

study 2019. BMC Urol. 2024;24(1):1-15.

2. Xiong Y, Zhang Y, Li X, Qin F, Yuan J. The prevalence and

associated factors of lower urinary tract symptoms suggestive

of benign prostatic hyperplasia in aging males. Aging Male.

2020; 23(5):1432-9.

3. Krièkoviæ Z, Simatoviæ M, Lukiæ D, Stanojeviæ A, Škrbiæ

V, Janjiæ G. Frequency of common complications during

treatment of patients with benign prostate hyperplasia. Scr

Med. 2020; 51(1):48-53.

4. Bengtsen MB, Heide-Jørgensen U, Borre M, Nørgaard M.

Long-term risk of benign prostatic hyperplasia-related surgery

and acute urinary retention in men treated with 5-alpha

reductase inhibitor versus alpha-blocker monotherapy in

routine clinical care. Prostate. 2023; 83(10):980-9.

5. Parsons JK, Dahm P, Köhler TS, Lerner LB, Wilt TJ. Surgical

management of lower urinary tract symptoms attributed to

benign prostatic hyperplasia: AUA guideline amendment

2020. J Urol. 2020;204(4):799-804.

6. Hughes T, Harper P, Somani BK. Treatment algorithm for

management of benign prostatic obstruction: an overview of

current techniques. Life. 2023;13(10):2077.

7. Sinha MM, Pietropaolo A, Hameed BZ, Gauhar V, Somani

BK. Outcomes of bipolar TURP compared to monopolar

TURP: a comprehensive literature review. Turk J Urol.

2022;48(1):1.

8. Geremew LM, Gelaw SA, Beyene AD. Assessing the

complications of monopolar transurethral resection of the

prostate (M-TURP) using Clavien-Dindo complications

grading system. Ethiop J Health Sci. 2022;32(3).

9. Ottaiano N, Shelton T, Sanekommu G, Benson CR. Surgical

complications in the management of benign prostatic

hyperplasia treatment. Curr Urol Rep. 2022;23(5):83-92.

10. Mbaeri TU, Abiahu JA, Obiesie EA, Odo C, Oranusi KC,

Nwofor AME, et al. Assessment of complications of

transurethral resection of the prostate using clavien-dindo

classification in South Eastern Nigeria. Niger J Surg.

2020;26(2):142-6.

11. Dubey A, Tiwari SS, Patel P, Thakur AP. Using the modified

Clavien garding system to classify complications of bipolar

TURP. Int J Med Rev Case Rep. 2023;7(1):16-.

12. Nadjimitdinov Y, Akhmadaliev T, Khusanov S. Assessment

of complications of transurethral resection of the prostate

using the Clavien-Dindo Classification. Int J Med Sci.

2025;1(2):253-8.

13. Chaudhary A, Ahmed Z, Ahmed B, Ullah K, Lashari MK,

Qamar U. Frequency of grading of complications using

modified Clavien classification system after transurethral

resection of prostate. Professional Med J. 2021;28(06):848-

53.

14. Agrawal M, Kumar M, Pandey S, Aggarwal A, Sankhwar S.

Changing profiles of patients undergoing transurethral resection

of the prostate over a decade: a single-center experience. Urol

Ann. 2019;11(3):270-5.

15. Sagen E, Namnuan RO, Hedelin H, Nelzén O, Peeker R. The

morbidity associated with a TURP procedure in routine clinical

practice, as graded by the modified Clavien-Dindo system.

Scand J Urol. 2019;53(4):240-5.

16. Pan TT, Li SQ, Dai Y, Qi JX. Observation of complications

assessed by Clavien-Dindo classification in different

endoscopic procedures of benign prostatic hyperplasia: an

observational study. Medicine. 2023;102(2):e32691

17. Islam MM, Chowdhury MG, Islam MF, Khan SA, Rahman

H, Rahman A. Pattern of complications and their predictors

following transurethral resection of the prostate using the

modified Clavien Classification system. Bangladesh J Urol.

2024;27(2):115-24.

18. Shukla PK, Sharma V, Singh Thakur AP, Ghanghoria A,

Shukla V. Inter-observer reliability in reporting complications

of transurethral resection of the prostate with Clavien-Dindo

classification: a retrospective observational study. J Clin Diagn

Res. 2023;17(12).

19. Gravas SC, Cornu JN, Gacci M, Gratzke C, Herrmann TR,

Mamoulakis C, Rieken M, Speakman MJ, Tikkinen KA. EAU

guidelines on management of non-neurogenic male lower

urinary tract symptoms (LUTS) including benign prostatic

obstruction (BPO). Arnhem (NL): European Association of

Urology; 2024.

20. Rassweiler J, Teber D, Kuntz R, Hofmann R. Complications

of transurethral resection of the prostate (TURP) — incidence,

management, and prevention. Eur Urol. 2006;50(5):969-979

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Published

2026-01-14

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