OPEN PROSTATECTOMY

Abstract

Objectives: To study the morbidity of open prostatectomy. To assess
the frequency of complications after open prostatectomy. Study design: Descriptive cross sectional. Setting: Surgical
Unit-IV, DHQ Hospital, Faisalabad. Duration: 01-01-2003 to 31-12-2003 (One Year). Subjects: Patients of bladder
outlet obstruction due to benign prostatic hyperplasia (PBH) were operated by open surgery (Transvesical or retropubic
prostatectomy). Results: Open prostatectomy was performed in 54 cases. In 38 cases, suprapubic transvesical
prostatectomy was performed, while in 6 cases, retropubic prostatectomy was done. Our youngest patient was 42 years
old and oldest 90 years. Mean age was 62 years. In our study, the most common complications were wound associated
seen in 7(12.96%) cases. They included cellulites in 3(5.56%) cases, stitch abscess in 1(1.85%) cases, seroma in
1(1.85%) cases, and abscess in 2(3.70%) cases. Other complications were bleeding in the form of reactionary
haemorrhage/clot retention in 2(3.70%) cases and secondary haemorrhage in 3(5.56%) cases. Urinary fistula was seen
in 5(9.26%) cases while retrograde ejaculation in 6(11.11%) cases, stricture urethra in 3(5.56%) cases, urinary
incontinence in 4(7.41%) cases and urinary tract infection in 5(9.26%) cases. Epididimo-orchitis, deep vein thrombosis
and osteitis pubis were not seen in our study. The average duration of hospital stay was 6 days. Most cases were
discharged within five days of operation, while stitches were removed on the eighth postoperative day. Conclusions:
The morbidity of open prostatectomy is higher than transurethral resection (TURP), as TURP is better procedure due
to lower complication rate, short hospital stay, cost effectiveness and better tolerated by old and unfit patients,
presenting with small fibrotic prostate. Open prostatectomy is still a good option for BPH where TURP facilities are not
available.