Abstract
Introductiontransvesical (open) prostatectomy (OP), an invasive surgical procedure, is a common form of treatment offered to patients with benign prostatic enlargement in emerging economies. Recently, there has been an increase in the use of electrosurgical means in treating benign prostate hyperplasia in our environment, especially transurethral resection of the prostate (TURP). This study compares the perioperative, short-term outcomes and complications of open prostatectomy and TURP.Methodsthe records of men who had prostatectomies (OP and TURP) from Jan 2016 to Dec 2019 for prostate gland less than 80g were reviewed. The patients´ age, size of the prostate gland, duration of surgery (mins), blood transfusion, clot retention, length of catheterisation (days), hospital stay (days), postoperative infection, postoperative incontinence, reoperation, bladder neck stenosis and urethral stricture were analysed.Resultsfifty-nine patients were studied. Twenty-nine patients had OP, while 30 had TURP. Mean age for OP was 63.8 (SD 7.2) years, while for TURP is 68.5 (SD 8.0) years (p=0.019). The mean for length of catheterisation for OP vs TURP was 9.1 (SD 3.7) vs 3.3 (SD 1.03) days (p=0.001), mean hospital stay was 9.6 (SD 4.1) and 4.7 (SD 2.2) days (p=0.001) for OP and TURP while duration of surgery (mins) for OP and TURP was 106.7 (SD 15.2) vs 53.8 (SD 14.0) minutes (p=0.001). The blood transfusion rate was 13.8% and postoperative incontinence 13.8% in OP, while in the TURP group, the reoperation rate was 3.3% and urethral stricture at a rate of 3.3%. Overall complications showed no statistical difference (p=0.462) between the two groups.Conclusionthe patients who underwent TURP had shorter hospital stay, shorter duration of surgery and catheterisation, and less frequently required blood transfusion compared to those who had open prostatectomy. However, reoperation rate was higher compared to open prostatectomy. The overall complication was fewer with TURP, but this is not statistically significant; hence both forms of surgical therapy remain relevant in a poor resource setting.
Highlights
Benign prostatic hyperplasia is a non-malignant enlargement of the prostate gland
There has been an increase in the use of electrosurgical means in treating benign prostatic hyperplasia in our environment, especially transurethral resection of the prostate (TURP), a minimally invasive endourological procedure that employs a monopolar or bipolar current-based resection of the prostate [13,14,15]
In patients who had open prostatectomy, blood transfusion was required in four patients (13.8%) with postoperative incontinence occurring in 4 (13.8%), while there were no transfusions and no postoperative incontinence in the TURP group
Summary
It is a common disease that affects ageing men and may cause lower urinary tract symptoms [1,2]. These symptoms impair quality of life and can result in renal dysfunction [3]. After the age of forty, the prevalence of benign prostatic hyperplasia (BPH) increases in men. Recurrent urinary tract infection, failed voiding trials, recurrent gross haematuria and renal insufficiency secondary to obstruction are indications for prostatectomy. Other indications for prostatectomy include failed medical therapy, a desire to terminate medical therapy and financial constraints associated with medical therapy [6,7,8]
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