{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T20:37:54Z","timestamp":1776890274056,"version":"3.51.2"},"reference-count":38,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2023,1,1]],"date-time":"2023-01-01T00:00:00Z","timestamp":1672531200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therapeutic Advances in Urology"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:sec><jats:title>Background:<\/jats:title><jats:p> Transurethral resection of the prostate (TURP) under Monitored Anesthesia Care MAC\/Sedation (macTURP), as compared with TURP under general (genTURP) or spinal (spTURP) anesthesia, is a safer and infrequently used technique reserved for high-risk patients. <\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives:<\/jats:title><jats:p> The aim of this study is to compare 30-day postoperative outcomes of TURP using the three types of anesthesia techniques. <\/jats:p><\/jats:sec><jats:sec><jats:title>Design and methods:<\/jats:title><jats:p> The American College of Surgeons National Surgical Quality Improvement Program database was queried for patients who underwent TURP between 2008 and 2019. Demographics, lab values, medical history, and 30-day outcomes were compared. Univariate and multivariate regression models for postoperative complications were constructed. A propensity score\u2013matched analysis was then performed for genTURP and macTURP and for spTURP and macTURP as a sensitivity analysis. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p> A total of 53,182 patients underwent TURP. Older patients (&gt;80) with diabetes requiring insulin (7.9%), leukocytosis (7.4%), history of chronic obstructive pulmonary disease (COPD) (7.8%), dyspnea (7.2%), and of ASA\u2009&gt;\u20092 (58.8%) were more likely to undergo macTURP as compared with genTURP ( p\u2009&lt;\u20090.013). SpTURP showed lower rates of urinary tract infection (UTI) [odds ratio (OR)\u2009=\u20090.869] as compared with genTURP ( p\u2009=\u20090.049), whereas macTURP showed higher rates of major adverse cardiovascular events (OR\u2009=\u20092.179) as compared with genTURP ( p\u2009=\u20090.005). All other postoperative complications showed similar rates between the three procedures. The propensity-matched cohorts demonstrated that no differences in postoperative complication rates were noted between macTURP and genTURP and between macTURP and spTURP. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion:<\/jats:title><jats:p> MacTURP was found to be feasible with a good safety profile as compared with genTURP and spTURP. MacTURP could be used in elderly, frail, and co-morbid patients with a similar safety profile as compared with more invasive anesthetic techniques. <\/jats:p><\/jats:sec>","DOI":"10.1177\/17562872221150217","type":"journal-article","created":{"date-parts":[[2023,1,20]],"date-time":"2023-01-20T06:49:53Z","timestamp":1674197393000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Sedation as an alternative anesthetic technique for frail patients in transurethral resection of the prostate"],"prefix":"10.1177","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2475-4256","authenticated-orcid":false,"given":"Christian Habib","family":"Ayoub","sequence":"first","affiliation":[{"name":"Division of Urology, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Viviane","family":"Chalhoub","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care, Hotel-Dieu de France Hospital, Saint-Joseph University Medical School, Beirut, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adnan","family":"El-Achkar","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nassib","family":"Abou Heidar","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hani","family":"Tamim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon"},{"name":"College of Medicine, Alfaisal University, Riyadh, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie","family":"Maroun-Aouad","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, American University of Beirut Medical Center, PO BOX: 11-0236, Riad El Solh 1107 2020, Beirut, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Albert","family":"El Hajj","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgery, American University of Beirut Medical Center, PO BOX: 11-0236, Riad El Solh 1107 2020, Beirut, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2023,1,19]]},"reference":[{"key":"bibr1-17562872221150217","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2005.12.042"},{"key":"bibr2-17562872221150217","doi-asserted-by":"publisher","DOI":"10.1093\/bjaceaccp\/mkp012"},{"key":"bibr3-17562872221150217","doi-asserted-by":"publisher","DOI":"10.1097\/01.ju.0000155709.37840.fe"},{"key":"bibr4-17562872221150217","doi-asserted-by":"publisher","DOI":"10.7257\/1053-816X.2016.36.2.75"},{"key":"bibr5-17562872221150217","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000000574"},{"key":"bibr6-17562872221150217","doi-asserted-by":"publisher","DOI":"10.1159\/000442854"},{"key":"bibr7-17562872221150217","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2021.06.034"},{"key":"bibr8-17562872221150217","doi-asserted-by":"publisher","DOI":"10.1007\/BF01637376"},{"key":"bibr9-17562872221150217","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(17)58119-7"},{"key":"bibr10-17562872221150217","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(17)45829-0"},{"key":"bibr11-17562872221150217","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.1990.tb14952.x"},{"key":"bibr12-17562872221150217","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(17)50068-3"},{"key":"bibr13-17562872221150217","doi-asserted-by":"publisher","DOI":"10.1590\/S0041-87812002000600008"},{"key":"bibr14-17562872221150217","doi-asserted-by":"publisher","DOI":"10.1016\/0090-4295(94)90034-5"},{"key":"bibr15-17562872221150217","doi-asserted-by":"publisher","DOI":"10.1159\/000019536"},{"key":"bibr16-17562872221150217","doi-asserted-by":"publisher","DOI":"10.1177\/17562872221084847"},{"key":"bibr17-17562872221150217","unstructured":"ACS NSQIP. 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