Patients who underwent prostatic adenomectomy with comorbidity during the study period and who agreed to participate in the study after informed consent were included in this study.

Patients received for pathologies other than BPH were not included in our study;

All patients admitted for BPH and comorbidity who have not undergone surgery;

All patients who underwent adenomectomy without comorbidity.

Our study variables were divided into:

Epidemiological variables: Proportion; age.

Reasons for consultation: these are the signs and/or symptoms that led the patient to see a doctor. These are: pollakiuria; burning when urinating; urgency, dysuria; the RAUV; the RCIUV; the RCCUV.

Presence of one or more disease states associated with adenomectomy: Diabetes; high blood pressure (HTA); cerebrovascular accident (CVA); the Human Immunodeficiency Virus (HIV); chronic renal failure; obesity.

These are the signs highlighted by the examining doctor at the consultation including: AEG, lumbar contact, bladder globe, rectal examination data, etc.

· Transvesical adenomectomy of the prostate: is the surgical removal of the adenoma of the prostate by the transvesical route.

· Trans-urethral resection of the prostate: Consists of removing the prostate adenoma in small shavings through a resector equipped with a camera under a stream of water and a cold light.

· Millin (Retro pubic adenomectomy): this is the removal of the prostate via the retro pubic route.

The Results were Favorable or unfavorable (complications).

The complications were classified as follow: Compartment hemorrhage, obstructive renal failure, parietal suppuration, urinary infection, epididymitis orchid, retention of urine after removal of the probe, vesicocutaneous fistula, death.

- the information was collected anonymously and confidentiality was required;

- We declare no conflict of interest for the production and dissemination of the results.

The average age of our patients was 70.43 years ± 8.74. The most represented age group was 70 - 79 years. This result is comparable to those of Bagayogo et al. [10] in Senegal in 2018 at the Aristide Le Dantec University Hospital who reported that the average age of patients was 70.9 ± 9.2 years with a predominance in the 70 to 79 age group.

On the other hand, close to that of Botcho G et al. [9] in Togo in 2018 at the Kara University Hospital who reported that patients aged 60 to 69 years were the most affected with an average of 69.3 years and extremes of 42 to 98 years. The occurrence of prostate pathologies over the ages of 50 would explain this predominance.

The reasons for consultations were dominated by nocturnal urinary frequency followed respectively by day time urinary frequency and incomplete bladder emptying. This result is comparable to that of Robert G et al. [2] in France in 2018 which showed that the most frequently reported symptoms were respectively nocturnal urinary frequency (present in 48.6% of patients), the presence of terminal drops (14.2%), and the sensation of emptying incomplete bladder (13.5%). This could be explained by the fact that lower urinary tract symptoms occur more often in men in their fifties.

Regarding comorbidities, high blood pressure was the most common, followed by diabetes. Our results are in the same direction as those of Botcho G et al. [9] in Togo in 2018 who reported in their study carried out on 73 patients, 55 patients (72.37%) had at least one comorbidity factor with a predominance of arterial hypertension (hypertension) in 33 cases (43, 42%). Other comorbidity factors were diabetes in 19 cases (25%). This relatively high hypertension rate would explain the increasing incidence of cardiovascular diseases occurring with age after fifty.

Regarding the PSA level, almost half of our patients had a level between 4 and 10 ng/ml. Our study contrasts with that of Bagayogo et al. [10] in Senegal in 2018 who found that the PSA level was greater than 10 ng/ml in the majority of their patients, i.e. 61.1%. The acute and chronic retention of urine and in addition a large prostate volume encountered in most of our patients would explain the elevation in the total PSA level.

Ultrasound was systematic in all our patients. We found that prostate volume varied from 31 ml to 223 ml with an average of 84.141. Our data is close to that of Botcho G et al. [9] in Togo in 2018 who showed that prostate ultrasound had found a prostate volume which varied from 35 ml to 285 ml with an average of 104.7 ml. Our ultrasound results on prostate volume suggested that the majority of our patients had a fairly high prostate volume.

Compared to the isolation of Escherichia Coli, our study is inferior to that of Adakal O et al. [3] in Niger in 2021 who reported in their series that Escherichia Coli was isolated in 65.5% of urine cultures. Bagayogo et al. [10] in Senegal in 2018 showed that the cytobacteriological examination of urine (ECBU) revealed a urinary infection in half of the patients, i.e. 50%. Escherichia coli and Cytrobacter freundi were the most incriminated germs. It would be beneficial for these infections to benefit from early diagnosis and effective management to avoid associated infectious complications.

Speaking of the management, trans-bladder adenomectomy of the prostate took first place followed by trans-urethral resection of the prostate. Our data can be superimposed on that of Debbagh A et al. [11] in Morocco in 2002 who showed in their series that transvesical adenomectomy was first (50.4%) followed by endoscopic resection (49.6%). The presentation of large prostate volumes and the high cost of equipment would explain this result.

In our study, complications were dominated by surgical site infection and urine retention after removal of the catheter. Our result is contrary to that of MB Diallo et al. [12] in Guinea in 2001 who showed in their study that the first complication was vesicocutaneous fistula 15.6%, followed by epididymitis orchitis 11.5%.

In our study the average length of hospitalization was 9 days with extremes of 5 and 20 days. Our result is superimposable to that of Botcho G et al. [9] in Togo in 2018 who showed in their study that the average duration of hospitalization was 9 days with extremes of 5 to 21 days.

Infection of surgical wounds associated with diabetes contributed to the prolongation of the duration of hospitalization days.

Diabetes was statistically associated with the occurrence of surgical site infection with a p-value of 0.003. This association could be explained by the fact that diabetes promotes infections.