Risk of acute myocardial infarction after transurethral resection of prostate in elderly

Claudio De Lucia, Grazia Daniela Femminella, Giuseppe Rengo, Antonio Ruffo, Valentina Parisi, Gennaro Pagano, Daniela Liccardo, Alessandro Cannavo, Paola Iacotucci, Klara Komici, Carmela Zincarelli, Carlo Rengo, Pasquale Perrone-Filardi, Dario Leosco, Fabrizio Iacono, Giuseppe Romeo, Bruno Amato, Nicola Ferrara

Research output: Contribution to journalArticle

Abstract

Background: Benign prostatic hyperplasia is a frequent disease among elderly, and is responsible for considerable disability. Benign prostatic hyperplasia can be clinically significant due to lower urinary tract symptoms that take place because the gland is enlarged and obstructs urine flow. Transurethral resection of the prostate remains the gold standard treatment for patients with moderate or severe symptoms who need active treatment or who either fail or do not want medical therapy. Moreover, perioperative and postoperative surgery complications as cardiovascular ones still occur. The incidence of acute myocardial infarction in patients undergoing transurethral resection of the prostate is controversial. The first studies showed an increase in mortality and relative risk of death from myocardial infarction in transurethral resection of the prostate group vs open prostatectomy but these results are in contrast with more recent data. Discussion. Given the conflicting evidence of the studies in the literature, in this review we are going to discuss the factors that may influence the risk of myocardial infarction in elderly patients undergoing prostate surgery. We analyzed the possible common factors that lead to the development of myocardial infarction and benign prostatic hyperplasia (cardiovascular and metabolic), the stressor factors related to prostatectomy (surgical and haemodynamic) and the risk factors specific of the elderly population (comorbidity and therapies). Summary. Although transurethral resection of the prostate is considered at low risk for severe complications, there are several reports indicating that cardiovascular events in elderly patients undergoing this surgical operation are more common than in the general population. Several cardio-metabolic, surgical and aging-related factors may help explain this observation but results in literature are not concord, especially due to the fact that most data derive from retrospective studies in which selection bias cannot be excluded. Subsequently, further studies are necessary to clarify the incidence of acute myocardial infarction in old people.

Original languageEnglish
Article numberS35
JournalBMC Surgery
Volume13
Issue numberSUPPL.2
DOIs
Publication statusPublished - 2013

Keywords

  • Benign prostatic hyperplasia
  • elderly
  • heart failure
  • myocardial infarction
  • physical activity
  • transurethral resection of prostate

ASJC Scopus subject areas

  • Surgery

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  • Cite this

    De Lucia, C., Femminella, G. D., Rengo, G., Ruffo, A., Parisi, V., Pagano, G., Liccardo, D., Cannavo, A., Iacotucci, P., Komici, K., Zincarelli, C., Rengo, C., Perrone-Filardi, P., Leosco, D., Iacono, F., Romeo, G., Amato, B., & Ferrara, N. (2013). Risk of acute myocardial infarction after transurethral resection of prostate in elderly. BMC Surgery, 13(SUPPL.2), [S35]. https://doi.org/10.1186/1471-2482-13-S2-S35