Transurethral Resection of the Prostate: A 3 Year Experience

Abstract

Background: Transurethral resection of the prostate (TURP) is considered the 'gold standard' in the surgical management of bladder outlet obstruction secondary to benign prostatic hyperplasia and advanced carcinoma of the prostate. The procedure is however still not routinely available in most public health institutions in Nigeria. We present our experience with this treatment modality over a three year period Methods: The records of patients who underwent TURP over a period of three years (April 2006 May 2009) were examined. The biodata, Laboratory investigations, detail of the surgical procedure and outcome were extracted and analysed Results: The records of forty three patients were examined. The age range was 49 76yrs (mean 65yrs +/-5.8 SD). The prostate specific antigen ranged from 1.3 50.3ng/ml (mean 13.3 +/-12.8). The mean prostate size was 59g +/-20 SD (range 27 98grams). The indications for the surgery included refractory acute urinary retention 48.8%, failed medical treatment 21%, recurrent UTI 16%, recurrent haematuria 9%, chronic urinary retention 2%. The mean duration of surgery was 80.5mins +/-14 SD (range 60 120mins). The period of hospital stay ranged from 3 32 days (mean 8.7 days +/-7.7 SD). Complications included capsular perforation in 2 patients, TURP syndrome in 2 patients, total incontinence in 1 patient and failure to void in 2 patients. Most patients (93%) had satisfactory voiding and insignificant post void residual urine volume during subsequent follow up visits Conclusion: Transurethral resection of prostate is a safe and effective treatment modality in the surgical management of men with bladder outlet obstruction secondary to BPH and advanced CAP in our environment.

Monopolar trans-urethral resection of prostate: our initial experience in a new African hospital with few resources

“…Recurrent urine retention secondary to BPH was the predominant indication for TURP as shown in (Table 1), this is similar to the previous study in Nigeria, and perhaps, it is among the top list of indications according to the current EAU guidelines. 5,10 In this study, sterile distilled water was used as irrigation fluid during TURP in all the cases, this is similar to its successful use due to its availability, affordability and safety as reported by earlier studies. 7,9,11 The mean weight of resected prostatic tissues in our study was 18.4 grams, which is close to the mean weight of 20.7 grams during TURP cases in 2010 reported by Young et al 12 However, another study in Nigeria revealed a larger mean/ average resected tissue weight of 59.8 grams, this could probably be due to their huge sample size of 502 patients compared to ours.…”

“…14 Study by Chukwujama et al reported mean duration of hospital stay of 8.7 days longer than ours, this was attributed to the presence of diabetes, chronic kidney disease and occurrence of capsular perforation in their series, which were completely absent in our study. 10 In our study one of the patient developed haemorrhage with clot retention intra-operatively, it was difficult to control, hence necessitated conversion to open trans-vesical prostatectomy and had satisfactory post-operative outcome. Every endo-urologist should be well equipped with sound knowledge and skills of open urological procedures, in other to salvage himself in case of eventualities.…”

Assessment of complications of transurethral resection of the prostate using Clavien-Dindo classification in South Eastern Nigeria

“…This is similar to the mean age in related studies which reported mean ages of 66.1, 65 ± 5.8, 67.2, 66.1 ± 8.6, and 67.07 ± 9.38 among patients with benign prostate hyperplasia in Nigeria. [ 10 11 12 13 14 ] It is also similar to the mean ages of similar studies done in the UK (70 years), Greece (68.4 years), India (66.94 years), and Italy (70.1 years). [ 5 15 16 17 ]…”

“…[ 7 21 22 23 ] The transfusion rate of 11.34% observed in our study is higher than the transfusion rate ranging from 0.4% to 8.6% observed in developed countries,[ 7 20 24 ] but lower than 40% reported by an earlier study in our region. [ 11 ] Our transfusion rate, however, dropped with increasing experience and confidence with the procedure.…”

“…The complications that can arise from TURP have been extensively documented in a number of studies. [ 7 8 11 18 19 20 ] The main aim of this study is to audit the complications arising in men who had TURP in a developing economy where TURP is beginning to gain popularity using a validated classification system, CDCS. This is important for proper planning, patients counseling, and comparing results.…”