Complications after surgery for benign prostatic enlargement: a population-based cohort study in Ontario, Canada

ObjectivesTo examine the complication rates after benign prostatic enlargement (BPE) surgery and the effects of age, comorbidity and preoperative medical therapy.DesignA retrospective, population-based cohort study using linked administrative data.SettingOntario, Canada.Participants52 162 men≥66 years undergoing first BPE surgery between 1 January 2003 to 31 December 2014.InterventionMedical therapy preoperatively and surgery for BPE.Primary and secondary outcome measuresThe primary outcome was overall 30-day postoperative complication rates. Secondary outcomes included BPE-specific event rates (bleeding, infection, obstruction, trauma) and non-BPE specific event rates (cardiovascular, pulmonary, thromboembolic and renal). Multivariable analysis examined the association between preoperative medical therapy and postoperative complication rates.ResultsThe 30-day overall complication rate after BPE surgery was 2828 events/10 000 procedures and increased annually over the study period. Receipt of preoperative α-blocker monotherapy (relative rate (RR) 1.05; 95% CI 1.00 to 1.09; p=0.033) and antithrombotic medications (RR 1.27; 95% CI 1.22 to 1.31; p