A descriptive study of transvesical prostatectomy outcomes at a general hospital in Addis Ababa, Ethiopia

Abstract

Background: Benign prostatic hyperplasia (BPH) affects more than 50% of men over 60 years of age and is the most common cause of bladder outlet obstruction and voiding symptoms in elderly men. Open prostatectomy—either transvesical or retropubic—remains the standard definitive treatment for BPH in some centres, especially in developing countries. 

Methods: This study was undertaken at Ras Desta Hospital, a regional hospital run by the Addis Ababa Health Bureau. The study was conducted between 1 January 2011 and 31 December 2013, during which time 195 patients underwent surgery for BPH. Of these, 154 patients had preoperative and postoperative records sufficient for comparison and analysis. Data were analysed using SPSS version 20. 

Results: Fourteen patients (9%) were between 40 and 49 years of age, 41 (27%) were 50 to 59 years old, and 67 patients (44%) were between 60 and 69 years of age. Sixty-one of the patients (40%) of patients had one or more episodes of acute urinary retention and had a history of catheterization for bladder outlet obstruction. Immediate postoperative complications were seen in 10 patients. Two patients had transient incontinence after transvesical prostatectomy, and 1 patient had permanent incontinence. There was also 1 clot retention, 2 suprapubic leaks, and 4 wound infections. One patient reported retrograde ejaculation. 

Conclusions: Given the limited availability and high costs associated with transurethral resection of the prostate, open prostatectomy remains an appropriate alternative in Ethiopia. The complication rates associated with open prostatectomy are minimal when the procedure is performed by adequately trained personnel. However, BPH patients often present to hospital after several serious complications. Therefore, more efforts should be made towards improving community awareness. 

Keywords: benign prostatic hyperplasia; BPH; open prostatectomy; transvesical; Ethiopia