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

Abstract

BackgroundBenign 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.DiscussionGiven 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).SummaryAlthough 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.

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Cardioprotective Effects of Dietary Phytochemicals on Oxidative Stress in Heart Failure by a Sex-Gender-Oriented Point of View

“…However, women tend to be older than men at diagnosis and exhibits a different phenotype: the HF with preserved ejection fraction (HFpEF) is more frequent in women and new onset of HF with reduced ejection fraction (HFrEF) in men [10]. Moreover, despite women with present HF at an older age, where comorbidities are more frequent, some studies showed that women have a lower cardiovascular and all-cause mortality [11,12], suggesting that the phenotypic differences in HF presentation and prognosis between women and men may be the consequence of progressive, sex-specific changes in cardiac and vascular physiology. Furthermore, the menopausal transition may influence the development of cardiovascular risk factors in women [13].…”

Nursing assessment of TURP syndrome: a pilot study

“…Transurethral resection prostate (TURP) is a gold standard surgery to overcome the problems of prostate gland enlargement (El-Hakim, 2010;De Lucia et al, 2013). TURP can be performed by considering certain clinical manifestations including post-void residual volume, recurrent haematuria and urinary retention, acute kidney failure and urolithiasis (Chamber, 2002;Rassweiler et al, 2006).…”