Postoperative complications following open and laparoscopic radical prostatectomy: A retrospective analysis using the Clavien-Dindo classification

Introduction/Objective. Prostate cancer is the most commonly diagnosed malignancy in men in more than half of the world’s countries and a leading cause of cancer death. Radical prostatectomy is the standard surgical treatment but carries a risk of postoperative complications. The aim of this study was to analyze postoperative complications after open and laparoscopic radical prostatectomy using the Clavien-Dindo classification. Methods. A retrospective study included 304 patients with prostate cancer treated at the Clinic of Urology, University Clinical Center of Vojvodina, from 2020 to 2024. Complications occurring within 60 days of surgery were graded using the Clavien-Dindo classification and analyzed in relation to sociodemographic, preoperative, intraoperative, and postoperative factors. Results. The mean age was 67.4 ± 5.7 years. Most complications were mild (Grade I, 47%; Grade II, 35.2%); the most frequent were blood transfusion (18.7%) and elevated serum creatinine (10.9%). Complication severity correlated significantly with body mass index (ρ = 0.169, p < 0.01), preoperative prostate-specific antigen (ρ = 0.167, p < 0.01), operative duration (ρ = 0.719, p < 0.001), and intraoperative blood loss (ρ = 0.552, p < 0.001). Sociodemographic factors showed no significant association. The difference between the open and laparoscopic approaches was not statistically significant (p = 0.295). Conclusion. Postoperative complications after radical prostatectomy were predominantly mild. Body mass index, prostate-specific antigen, operative duration, intraoperative blood loss, and the postoperative course were associated with greater complication severity, whereas the surgical approach was not.