Open Prostatectomy among Elderly Patients at The University of Maiduguri Teaching Hospital, North Eastern Nigeria

Abstract

Background: The elderly, 80 years and above are increasingly being seen in clinical practice presenting with benign prostatic hyperplasia  more often late with high rate of complications at presentation, larger prostates, coupled with intercurrent medical conditions related to  aging and in an environment lacking facilities and expertise for minimally invasive procedures.

Objectives: To review the presentation,  management and outcome of open prostatectomy for benign prostatic hyperplasia in elderly patients 80years and above.

Materials and  Method: Elderly patients 80-years and above that underwent open prostatectomy in the University of Maiduguri Teaching Hospital  (UMTH) between January 2001 and December 2010 were studied. Data were obtained from clinical notes and laboratory records and  analysed.

Results: Sixty-two patients, aged 80 to 116 years were reviewed. Duration of symptoms ranged from 6 to 168 months with a  mean of 25 months. Major symptoms at presentation were urinary frequency in 57 patients (91.9%), poor urinary stream in 55 (88.7%) and difficulty in passing urine in 39 (62.9%) while 30(48.4%) presented with acute retention. Complications at presentation were hernia in  19 (30.6%), urolithiasis 16 (25.8%), haemorrhoids 13 (21%), UTI and impaired renal function 12 (19.4%) each. Intercurrent medical  conditions at presentation were hypertension / cardiomyopathy in 27 (43.5%), arthritis 13 (21%), Parkinsonism 8 (12.9%) and diabetes  mellitus 6 (9.7%).

Conclusion: Open prostatectomy in the elderly despite late presentation, intercurrent medical conditions and larger  prostates is still very safe with associated low morbidity and mortality provided patients are optimised.