Perioperative Complications of Transurethral Resection of The Prostate According to Clavien Classification System

Rateb abd alrazaq Daowd, Adnan Ahmad, Mossab Al Refaie


Purpose: The aim of the study was to evaluate the applicability of the modified Clavien classification system (CCS) in grading perioperative complications of transurethral resection of the prostate (TURP).
Methods: All patients with benign prostatic hyperplasia submitted to monopolar TURP from January 2011 to February 2013 at hospitals of Damascus University were evaluated for complications occurring up to the end of the first postoperative month. All complications were classified according to the modified CCS. If multiple complications per patient occurred, categorization was done in more than one grade. Results were presented as complication rates per grade.
Results: Forty-four complications were recorded in 31 out of 198 patients (overall perioperative morbidity rate: 15.7%), and their grading was generally easy, non-time-consuming and straightforward. Most of them were classified as grade I (59.1%) and II (29.5%). Higher grade complications were scarce (grade III: 2.3% and grade IV: 6.8%, respectively) There was one death (grade V: 2.3%) due to acute myocardial infarction (overall mortality rate: 0.5%). Negative outcomes such as mild dysuria during this early postoperative period or retrograde ejaculation were considered sequelae and were not recorded. Nobody was complicated with severe dysuria. There was one re-operation due to residual adenoma (0.5%).
Conclusions: The modified CCS represents a straightforward and easily applicable tool that may help urologists to classify the complications of TURP in a more objective and detailed way. It may serve as a standardized platform of communication among clinicians allowing for sound comparisons.


Benign prostatic hyperplasia, Complications, Transurethral resection of prostate

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