Suprapubic transvesical prostatectomy in a rural Kenyan hospital.

Abstract

To evaluate the effectiveness, safety and complications of suprapubic transvesical prostatectomy in a rural Kenyan hospital. A prospective audit of suprapubic transvesical prostatectomy. Africa Inland Church, Kijabe Hospital, Kijabe, Kenya. One hundred and six men with lower urinary tract obstruction, clinically due to benign prostatic hyperplasia, undergoing suprapubic transvesical prostatectomy. Suprapubic prostatectomy. Age, presentation, comorbidity, type of anaesthesia, pathology, bladder irrigation time, Foley time, post-operative stay, complications-mortality, blood transfusion rate, return to theatre for bleeding, incontinence, urine leak, urinary retention. One hundred and six men entered the study with a mean age of 72.8 years. Seventy eight per cent were in retention and 25% had significant medical problems. Spinal anaesthesia was used in 94%. The mean prostate weight was 70.4 g and 11% had carcinoma. The Foley's catheter was removed at a mean of 4.2 days after surgery and the mean post-operative stay was 6.0 days. The 30 day mortality was 0.9%, the blood transfusion rate was 4.7%, the return to theatre for bleeding rate was 0.9% and 4.7% of patients developed a urine leak. Suprapubic transvesical prostatectomy, performed under spinal anaesthetic, by general surgeons in rural Kenya, is a safe and effective way of managing benign prostatic hyperplasia and its complications.