Perioperative Complications and Associated Factors Following Transurethral Resection of the Prostate Among Patients at Benjamin Mkapa Hospital, Tanzania

Abstract Introduction: Transurethral resection of the prostate (TURP) remains the gold standard surgical treatment for moderate to severe lower urinary tract symptoms (LUTS) secondary to benign prostate enlargement (BPE). Despite its effectiveness, TURP is associated with several perioperative complications which varies across settings. In Tanzania, evidence on complication rates and associated factors remains limited. This study assessed the prevalence and determinants of perioperative complications following TURP at Benjamin Mkapa Hospital between 2021 and 2023. Methods An analytical cross-sectional study was conducted using routinely collected data from the Medipro-5 and Mapping Tag ERX systems at BMH, included men aged ≥ 40 years diagnosed with BPH who underwent TURP and had at least one year of postoperative follow-up. Patients with prior prostate/urethral surgery, neurogenic bladder, or incidental prostate cancer were excluded. Descriptive statistics summarized patient characteristics. Modified Poisson regression with robust error variance estimated crude and adjusted prevalence ratios (aPRs) with 95% confidence intervals (CIs) for factors associated with complications, and p < 0.05 being considered statistically significance. Results Among 705 eligible men (mean age 69 ± 8.9 years), 18.7% experienced at least one complication. Ejaculatory dysfunction (10.4%) and urethral stricture (4.5%) were the most frequent complications. Based on the Clavien-Dindo classification: 10.4% were grade I, 2.3% grade II, 7.6% grade III, and 0.6% grade IV. In adjusted analysis, increasing age (aPR = 1.11; 95% CI: 1.11–1.13), catheterization > 3 days (aPR = 3.10; 95% CI: 1.58–6.06), hypertension (aPR = 1.30; 95% CI: 1.09–1.24), and diabetes (aPR = 1.85; 95% CI: 1.22–2.80) were significantly associated with higher prevalence of complications. However, TURP mode showed no significant association (p = 0.575) Conclusion Nearly one-fifth of men undergoing TURP at BMH developed postoperative complications, mostly mild but clinically important. Older age, prolonged catheterization, hypertension, and diabetes increased complication risk. Strengthening perioperative optimization may improve outcomes