Retropubic Prostatectomy- Innovations to Reduce Complications Leading to Smooth Recovery

Abstract

Introduction: Open prostatectomy/adenoma enucleation remains a valuable surgical option in treating large obstructing prostates in patients with large gland volume. We report our series of retropubic prostatectomies with innovative methods to reduce the complications and lead to smooth recovery. Patients and Methods: A total of 75 patients with B PH were treated by retropubic prostatectomy from 2005 to 2015. Patient’s demographical, clinical, pre- and postoperative data and final histology were recorded. 3 way Foley’s catheter before surgery was kept in the bladder and haemostasis was obtained by applying traction over the prostatic fossa. Results: The mean weight of prostatic adenoma was 82 gm., the smallest being 70gm. and the largest 192gm. Only 2 patients required intra operative blood transfusion. The catheter was removed on the 5th post-operative day. 94% of the patients voided with a good stream with little discomfort after one week. only one patient had incontinence of urine which improved subsequently over a period of 6 to 8 weeks. There was no mortality and no re-exploration for clot retention was required in any patient, Conclusion: Millin's prostatectomy popularized over half a century ago continues to be a valuable option for the surgical treatment of high-volume prostate glands with excellent outcomes for patients with innovative methods.