OPEN PROSTATECTOMY

Abstract

Objectives: To study the morbidity of open prostatectomy. To assessthe frequency of complications after open prostatectomy. Study design: Descriptive cross sectional. Setting: SurgicalUnit-IV, DHQ Hospital, Faisalabad. Duration: 01-01-2003 to 31-12-2003 (One Year). Subjects: Patients of bladderoutlet obstruction due to benign prostatic hyperplasia (PBH) were operated by open surgery (Transvesical or retropubicprostatectomy). Results: Open prostatectomy was performed in 54 cases. In 38 cases, suprapubic transvesicalprostatectomy was performed, while in 6 cases, retropubic prostatectomy was done. Our youngest patient was 42 yearsold and oldest 90 years. Mean age was 62 years. In our study, the most common complications were wound associatedseen in 7(12.96%) cases. They included cellulites in 3(5.56%) cases, stitch abscess in 1(1.85%) cases, seroma in1(1.85%) cases, and abscess in 2(3.70%) cases. Other complications were bleeding in the form of reactionaryhaemorrhage/clot retention in 2(3.70%) cases and secondary haemorrhage in 3(5.56%) cases. Urinary fistula was seenin 5(9.26%) cases while retrograde ejaculation in 6(11.11%) cases, stricture urethra in 3(5.56%) cases, urinaryincontinence in 4(7.41%) cases and urinary tract infection in 5(9.26%) cases. Epididimo-orchitis, deep vein thrombosisand osteitis pubis were not seen in our study. The average duration of hospital stay was 6 days. Most cases weredischarged within five days of operation, while stitches were removed on the eighth postoperative day. Conclusions:The morbidity of open prostatectomy is higher than transurethral resection (TURP), as TURP is better procedure dueto lower complication rate, short hospital stay, cost effectiveness and better tolerated by old and unfit patients,presenting with small fibrotic prostate. Open prostatectomy is still a good option for BPH where TURP facilities are notavailable.