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Open prostatectomy: the safety and efficacy of this procedure in developing countries


Urology & Nephrology Open Access Journal
Abdikarim Hussein Mohamed, Hussein Ali Mohamud

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Abstract

Objective:  To  propose  the  efficacy  and  safety  of  open  suprapubic  transvesical prostatectomy. Benign prostate hypertrophy (BPH) affects the majority of men in their life after the age of 40 years and is the most common cause of lower urinary tract symptoms (LUTS). Despite the popularity of transurethral resection of the prostate (TURP), open prostatectomy remains suitable surgical options for the management in patients with benign prostate hypertrophy living in developing countries due to scarcities of endoscopic tools.

Method: In May 2018 to January 2020, 24 cases of benign prostate hypertrophy underwent suprapubic transvesical open prostatectomy at Mogadishu Somali Turkey Reccep Tayyip Erdogan Training and Research Hospital. The outcome of these cases was prospectively analyzed. All patients with a suspect of prostate cancer, and abnormal coagulation profile and patients with a high-risk group (high-risk comorbidities) were excluded from the study.

Result: The mean age of patients was 70.5 years with an age range of 50-90. The average prostate  size  was  146.5gr. Acute  urinary  retention  was  the  predominant  presentation followed by nocturia and urgency. The mean preoperative hemoglobin of the patients was  13.3±1.8  mg//dl.  The  average  intraoperative  bleeding  was  550ml  and  the  mean postoperative hemoglobin was 10.6±1.6mg/dl. The commonest postoperative complication was clot retention and the predominant concomitant condition was bladder stones. The mean hospital stay was 3.4±1.5 days.

Conclusion: Open prostatectomy is safe and effective operative management for benign prostate hyperplasia in developing countries due to scarcities of endoscopic equipment and larger sizes of the prostate gland on presentation.

Keywords

prostate, open prostatectomy, clot, acute urinary retention, bleeding, nocturia

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