Recently, the incidence of urothelial carcinoma among older patients has increased. Consequently, the number of transurethral resection of bladder tumors (TURBT) procedures performed in older adults has also shown an increasing trend. In this study, we investigated incidence and predictors of postoperative complication following TURBT in a general hospital with a large number of older patients.

Between January 2018 and December 2023, a total of 141 patients with clinically bladder cancer on cystoscopy who underwent TURBT were included in this study. All TURBTs were performed by one experimental urological surgeon. The complications within postoperative 30 days of the 141 patients were reviewed on the medical record and the risk factors were analyzed. All complications were classified according to Clavien-Dindo classification grading. Logistic regression analysis was used to identify the risk factors of postoperative complications.

Of the 141 patients, male and female were 113 and 28, respectively. The median age was 77 (70-83) years old. Pathological stage no malignancy, Ta, 1, pure carcinoma in situ (CIS) and 2 or higher were 18, 81, 22, 9 and 11, respectively. 97 patients (69%) were high grade cancer. The postoperative complications occurred in 49 patients (34.8%) and of those, 28 and 21 patients (20% and 15%) were classified as Clavien-Dindo grade I and grade II or higher, respectively. Of the all complications, gross hematuria was the most common. In a multivariable analysis, a lower platelet counts (OR 0.89, P <0.01) and pathological T2 or higher (OR 5.51, P = 0.03), and bigger tumor size (OR 1.05, P <0.01) were significant and independent risk factors of postoperative complication, however, older age was not.

The incidence of postoperative complications following TURBT in older patients was almost same compared to that in younger patients, and older age was not significant and independent risk factor of postoperative complication. Accordingly, even if the patient is older age, surgeon with enough skill can perform TURBT safely.