TITLE:
Open Prostatectomy in the Management of Benign Prostate Hyperplasia in a Developing Economy
AUTHORS:
Abdulkadir A. Salako, Tajudeen A. Badmus, Afolabi M. Owojuyigbe, Rotimi A. David, Chinedu U. Ndegbu, Chigozie I. Onyeze
KEYWORDS:
Open Prostatectomy, Benign Prostate Hyperplasia, Developing Economy, Nigeria
JOURNAL NAME:
Open Journal of Urology,
Vol.6 No.12,
December
12,
2016
ABSTRACT: Background: Open prostatectomy (OP) is
still relatively common in developing countries and remains a useful benchmark
against which the minimal access surgical techniques are compared. This study
aims to document the indications and outcomes of OP in a typical developing
economy. Method: The records of patients with benign prostate hyperplasia (BPH)
who had OP in our university teaching hospital between July 2004 and June 2014
were retrospectively reviewed. Some analyzed parameters include the demographic
characteristics, indications, pre-operative work-up, anaesthetic techniques, OP
type, complications, histopathology results and follow-up duration. Results: A
total of 247 cases were studied. Mean age was 67 years while the commonest
surgery indication was recurrent acute urinary retention. Average prostate
specific antigen (PSA) was 8.4 ng/ml while hypertension was the most common comorbidity
(44.1%). Regional anaesthesia was mainly used (79.4%) while retropubic
prostatectomy was the commonest OP type done (58.7%). The enucleated specimen
weighed above 60 g in 91.9% of cases. All our patients were able to micturate
spontaneously with urine stream above 20 mls/second on follow-up one week after
discharge. Mean duration of hospital admission and follow-up were 7 days and 9
months respectively. Complications occurred in 90 patients (36.4%), of which
surgical site infections were the commonest (9.8%). There was 0.4% mortality.
Histopathology results showed BPH (95.5%), (incidental) prostate adenocarcinoma
(2.4%) or prostatic intra-epithelial neoplasia (2.1%). Conclusion: OP remains
an important therapeutic option for management of BPH in developing countries
partly due to relatively large prostate size and presence of BPH complications
from late presentationin many patients. The surgery is efficient and has
relatively low morbidity and minimal mortality.