Predictive factors for conversion of transurethral resection of the prostate to open prostatectomy

Objective: To evaluate the factors for the conversion of transurethral resection of the prostate(TURP) to open prostatectomy and to provide clinical evidence for surgical options.Methods: From January 1997 to March 2005,we performed 1 086 TURP and made retrospective analyses of 11 risk factors concerning the demographics,clinical history, laboratory data,ultrasound results,and intraoperative complications of the patients.In addition,multivariate logistic regression was used to determine those variables predicting the conversion of TURP.Results: Thirty-nine(3.59%) of the TURP cases required conversion,mostly because of uncontrollable hemorrhage(71.79%).Multivariate analyses showed that a prostate volume85.2 ml(OR =2.568,P0.01),intraoperative slit of capsula prostatica(OR =1.916,P0.01)and a second midstream bladder specimen(VB2) white blood cell count of the urine 13.5/HP(OR=1.486,P0.01) predicted the conversion to open prostatectomy.Conclusion: Benign prostatic hyperplasia(BPH) patients with a huge prostate and those with intraoperative slit of capsula prostatica undergoing TURP are more likely to be converted.And uncontrollable hemorrhage,huge prostate and poor endoscopic vision are the major reasons for the conversion.