The safety and efficacy of trans-vesical prostatectomy done at a primary general hospital setting in Ethiopia
AbstractBackground: BPH is a common problem in aging men. It is characterized by lower urinary tract symptoms (LUTS) and some time may be associated with urinary incontinence and sexual dysfunction. to investigate the safety and efficacy of trans-vesical prostatectomy donein a primary general hospital setting with limited facilities in Ethiopia.
Methods: This was a prospective cross sectional hospital based non-randomized study with a mean follow up of three months after operation. A total of 64 men were listed for Trans-vesical elective prostatectomy because of LUTS due to BPH. Co-morbidity, I-PSS, Indications, complications of anesthesia, weight of Prostate adenoma, duration of surgery, complications of surgery and patient satisfaction after surgery were studied.
Results: the mean age of presentation was 63.8 +/- 9.9 years. Fifty four(84.4%) presented with one or more complication of Bladder out flow obstruction(BOO), of which acute urine retention(AUR) was the leading complication occurring in 52 (81.3%) followed by recurrent UTI in 39 (60.9%) patients. The average duration of indwelling catheter before surgery was 6.5 weeks, with a median of 4 weeks and a range of 3days to 52 weeks. Spinal anesthesia was used in all except three patients and the average weight of prostate adenoma enucleated was 73.6 +/- 32.2 grams. An indwelling three way Foley catheter was required postoperatively for 4.7 +/- 1.7 days. The mean operative time was 49.7 +/- 13.2 minutes and no death was encountered in this series. There was no early complication seen in 54 (84.3%) patients and blood transfusion was needed for only 3 (4.6%). Only one patient required re-admission for bladder neck stenosis. The international prostate symptom score (I-PSS) decrease from 32.8 +/- 3.1 to 2.4 +/- 1.1 and patients were generally satisfied with the out come of surgery.
Conclusion: Trans-vesical prostatectomy is still safe and effective method of relieving BOO due to BPH in the primary general hospital setting with comparable outcome to the current alternative treatment.