Abstract
Background: Benign prostatic enlargement, the most common cause of lower urinary tract obstruction in elderly men is commonly associated with Lower Urinary Tract Symptoms (LUTS). Open prostatectomy is considered the operative treatment of choice. The aim of this study was to review our ten-year experience with open prostatectomy for huge prostates. Patient and methods: We retrospectively reviewed all patients that had open prostatectomy in University of Maiduguri Teaching Hospital from January 2001-December2010, whose prostates weighed 200 g or more. Results: Twenty-nine patients aged 60-97 years with a mean age of 76.3 ± 8.9 years were analyzed. The age group 80-89 years accounted for highest number of patients. All patients presented with lower urinary tract symptoms of frequency, poor urinary stream, and difficulty in passing urine, urgency/urge-incontinence, nocturia, and hesitancy. Others were incomplete bladder emptying, post-micturition dribbling, and overflow incontinence. Complications of bladder outlet obstruction at presentation were acute urinary retention, renal impairment, stones and haemorrhoids. Intercurrent medical conditions were mainly hypertension and diabetes. Conclusion: Open prostatectomy is the best option for patients with huge prostates, especially when associated with complications in elderly patients with intercurrent medical conditions.
Highlights
Benign prostatic enlargement is the most common cause of lower urinary tract obstruction in elderly men
All patients had open prostatectomy after resuscitation and continuous catheter drainage were necessary to ensure optimal renal function, and treating any urinary tract infection based on culture sensitivity
A total of 32 patients with huge prostates were found in the records
Summary
Benign prostatic enlargement is the most common cause of lower urinary tract obstruction in elderly men. In the developing world, where there is ignorance and lack of access to health facilities, patients present late with complications of bladder outlet obstruction (diverticulae, stones, impaired renal function etc) and large prostates all of which are indications for open prostatectomy [5]. This group of patients are elderly with inter-current medical conditions that are best treated by open surgery [6]. The most common cause of lower urinary tract obstruction in elderly men is commonly associated with Lower Urinary Tract Symptoms (LUTS). We retrospectively reviewed all patients that had open prostatectomy in University of Maiduguri Teaching Hospital from January 2001-December2010, whose prostates weighed 200 g or more
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