The malament suture: any role in transvesical prostatectomy?

Abstract

Background: We evaluated the role of the Malament suture in the development of bladder neck stenosis and in reducing transfusion requirements following transvesical prostatectomy for benign prostatic hyperplasia.
Methodology: This was a retrospective study done at the Jos University Teaching Hospital, a tertiary health institution in North Central Nigeria.
Results: There were 100 patients in the study, consisting of 41 who had and 59 who did not have the Malament suture applied during transvesical prostatectomy. Their ages ranged from 45 to 90(mean of 65.6 years). There were 26 complications in 17 patients (17% complication rate). Two patients who had the Malament suture applied and one patient who did not, developed bladder neck stenosis (p>0.05) after a mean follow up period of 5.5 years. Five patients in each group had clot retention (p>0.05) and a total of seven patients had excessive post operative haemorrhage (3 Malament, 4 without Malament, p>0.05). Twenty-five patients required blood transfusion (13 Malament, 12 without Malament, p=0.2 Yates corrected).
Conclusion: From our study, the Malament suture does not increase the incidence of bladder neck stenosis; neither does it reduce the need for blood transfusion. Prospective studies are required to further investigate these and find out if the Malament suture reduces the volume of fluid required for irrigation or the need to regularly review the patients.


Keywords: Prostatectomy, Benign prostatic hyperplasia, Malament suture

Sahel Medical Journal Vol. 10 (4) 2007: pp. 111-114