LAUSR

OBJECTIVES To determine the pre-operative assessment and peri-operative outcomes of men undergoing bladder outflow obstruction (BOO) surgery in the United Kingdom (UK) PATIENTS AND METHODS: A retrospective cohort study was conducted of all men undergoing BOO surgery in 105 UK hospitals over a 1-month period. The study included 1456 men, of whom 42% were catheter dependent prior to undergoing surgery. RESULTS There was no evidence that a frequency volume chart or urinary symptom questionnaire had been completed in 73% or 50% of men respectively in the non catheter dependent group. Bipolar TURP was the most common BOO surgical procedure performed (38%). Monopolar TURP was the next most prevalent modality (23%), however minimally invasive BOO surgical procedures combined accounted for 17% of all procedures performed. Of the cohort 5% of men suffered complications within 30 days of surgery, only 1% suffered ≥ Clavien Dindo Grade 3 complications. Less than 1% of the cohort received a blood transfusion after BOO surgery and 2% were readmitted to hospital after their BOO surgery. In total only 4% of the whole cohort were catheter dependent after BOO surgery. Pre- and post- operative paired IPSS scores reviewed suggest that minimally invasive surgical procedures achieved comparable levels of improvement in both symptoms and bother at 3 months post-operatively in men who were not catheter dependent pre-operatively. CONCLUSIONS There has been a substantial shift in the available choice of procedure for bladder outflow obstruction surgery around the UK in recent years. However men can be reassured that overall BOO surgery treatments are safe and effective. Evidence of adherence to guidelines in the pre-operative assessment of men with lower urinary tract symptoms undergoing surgery was poorly documented and must be improved.