Bleeding Prostate: A 10-year Experience in the University of Maiduguri Teaching Hospital (Umth); Nigeria

ABSTRACT

Background: Bleeding from an enlarged prostate gland is a major complication of benign prostatic enlargement (BPH). This review details our management over a 10-year period. Materials and Methods: A retrospective review of patients who presented with bleeding BPH between January 2001 and December 2010 was carried out to determine the outcome of management. Results: Forty-two patients with bleeding prostates treated by open prostatectomy were analyzed. The peak incidence was in the age group of 60-69 years. The main associated co-morbidities were hypertension in 17 (40.48) and diabetes in seven (16.67) patients. Urine culture was positive in 24 (57.14) patients; with E. coli in 13 (54.17) and Pseudomonas in four (16.67) patients as the main isolates. Most patients (37; 88.08) received blood transfusions ranging from two to four units. Operative techniques were transvesical in 30 (76.92) and retropubic in nine (23.08) patients. Isolated median lobe enlargement of the prostate was seen in 18 (46.15) and whole organ enlargement in 21 (53.85) patients. The weight of the prostates ranged from 47 to 403 g (mean; 127 g). Incidental carcinoma was seen in one patient (2.56). The mean hospital stay was 11 days (range 9-21); and the mean follow-up was 21 months (range 3-26). There was one (2.38) mortality. Conclusion: BPH with massive hematuria invariably has an enlarged median lobe and is managed by open prostatectomy; without risk of re-bleeding