Outcome of open prostatectomy

ABSTRACT

To determine the outcome of open prostatectomy in the general surgery department of rural setup. Descriptive case series. Department of Surgery, Fatima Hospital and Baqai Medical University Karachi, from June 2004 to May 2011. All patients with bladder outlet obstruction due to benign prostatic hyperplasia [BPH], operated by transvesical route were included. The parameters evaluated were improvement in International Prostate Symptom Score [IPSS], peak urinary flow [Qmax], postvoid residual urine [PVRU], blood transfusion rate, operative time, duration of catheterization, hospitalization and postoperative complications. There were 107 patients in the series. Mean age was 67 +/- 6 year [SEM=1]. The IPSS improved from 26.53 +/- 3.920 preoperatively to 9.13 +/- 1.797 postoperatively, PVRU from 136.094 +/- 31.802 to 18.86 +/- 5.694, and Qmax from 9.032 +/- 1.940 to 19.952 +/- 2.555. The postoperative complication rate was 46.7%. It included hemorrhage requiring transfusion [n=13 -15%], urinary tract infection [n=10 - 9.3%], wound infection [n=7 - 6.5%], clot retention [n=5 -4.7%], temporary urinary incontinence [n=3 -2.8%], bladder neck stenosis [n=3 - 2.8%], urethral stricture [n=2 -1.9%], suprapubic urinary fistula [n=2 - 1.9%], and epididymo-orchitis [n=1 - 0.9%]. The mortality rate was 0.9%. The mean operative, catherterization and hospitalization duration were 56.23 +/- 9.77 minutes, 7.12 +/- .81 days, and 8.41 +/- 2.28 days, respectively. Open prostatectomy is still a good option for BPH where endourology facilities are not available