Surgical management of benign prostate hyperplasia in Nigeria: open prostatectomy versus transurethral resection of the prostate

Abstract

Introduction transvesical (open) prostatectomy (OP), an invasive surgical procedure, is a common form of treatment offered to patients with benign prostatic enlargement in emerging economies. Recently, there has been an increase in the use of electrosurgical means in treating benign prostate hyperplasia in our environment, especially transurethral resection of the prostate (TURP). This study compares the perioperative, short-term outcomes and complications of open prostatectomy and TURP. Methods the records of men who had prostatectomies (OP and TURP) from Jan 2016 to Dec 2019 for prostate gland less than 80g were reviewed. The patients´ age, size of the prostate gland, duration of surgery (mins), blood transfusion, clot retention, length of catheterisation (days), hospital stay (days), postoperative infection, postoperative incontinence, reoperation, bladder neck stenosis and urethral stricture were analysed. Results fifty-nine patients were studied. Twenty-nine patients had OP, while 30 had TURP. Mean age for OP was 63.8 (SD 7.2) years, while for TURP is 68.5 (SD 8.0) years (p=0.019). The mean for length of catheterisation for OP vs TURP was 9.1 (SD 3.7) vs 3.3 (SD 1.03) days (p=0.001), mean hospital stay was 9.6 (SD 4.1) and 4.7 (SD 2.2) days (p=0.001) for OP and TURP while duration of surgery (mins) for OP and TURP was 106.7 (SD 15.2) vs 53.8 (SD 14.0) minutes (p=0.001). The blood transfusion rate was 13.8% and postoperative incontinence 13.8% in OP, while in the TURP group, the reoperation rate was 3.3% and urethral stricture at a rate of 3.3%. Overall complications showed no statistical difference (p=0.462) between the two groups. Conclusion the patients who underwent TURP had shorter hospital stay, shorter duration of surgery and catheterisation, and less frequently required blood transfusion compared to those who had open prostatectomy. However, reoperation rate was higher compared to open prostatectomy. The overall complication was fewer with TURP, but this is not statistically significant; hence both forms of surgical therapy remain relevant in a poor resource setting.

Practice of Endo-Urology in the Centre of Ivory Coast: Overview and Results

“…This result, which shows an age greater than 50 years, is in line with that reported by MAHAMAT in his study in N'DJAMERA, who reported an average age of 53.54 years [1]. Other authors such as DIAKITE [6] in MALI and OFOHA [7] in NIGERIA reported an average age of 62 and 63.8 years respectively. However, cases of patients under 50 years of age were reported by COULIBALY and colleagues in Côte d'Ivoire in their study of prostatic adenomectomy in twins [8].…”

A Retrospective Review of Open Prostatectomy in a Resource-Constrained Setting.

“…The median age of our study sample (68.5 years old) was within the age range reported for open prostatectomy case series from other resourceconstrained settings (63-73 years old) [4,5,9,10]. This finding suggests that older males in resourceconstrained settings, particularly those aged older than 60 years old, might benefit from prostate disease awareness campaigns and prostate disease screening interventions.…”

Early Removal of Foleys Catheter within 48 Hours of Transurethral Resection of the Prostate

“…5 There are many options with minimal invasive surgery but despite all TURP is a procedure of choice. 6 According to a previous study conducted by Chimaobi et al in Nigeria catheter was removed on the first post-operative day with the success rate of 98%. 7 Another study also reported it safe to remove the catheter on the same post-operative day without any major complication.…”