Long Term Outcomes of Trans Vesical Prostatectomy for Benign Prostatic Hyperplasia

Background. open prostatectomies either trans vesical or retropubic remains the reference standard for managing benign prostatic enlargement in some centers, especially in developing countries. When comparing minimally invasive procedures with open prostatectomy, the data for the latter are usually provided from old studies or from recent ones performed in developing countries. However, this procedure is still used frequently for large-size prostates. Methods. During a 2-year period, 212 patients with BPH underwent open trans vesical prostatectomy for symptomatic benign prostatic hyperplasia. Patient charts were retrospectively reviewed for preoperative, intra operative, and post-operative data in the three hospitals at Addis Ababa, Ethiopia between January 2019- December 2020 with the aim of assessing symptomatic improvement in post-operative urination, early and late postoperative complications. Results. Complete data evaluation was possible for 160 patients, with a minimum follow up period of 6 months. The mean age of the patient is 67.39 years (SD 9.3 years; range 45–95 years). Symptom improvement in LUTS during the early post-operative period (at 1month) was reported in 148(92.5%) and in late (6th month) 157(98.1%) cases. Long-term complications at 6 month and 1year follow up included urge incontinence in 8 (5%) at 6 month and 3(2.5%) at 1 year, stress incontinence in 4(2.5%) at 6 month and 3(1.9%) at 1year, urethral strictures in 4 (2.5) patients during 1 year follow up period out of 160 patients. Re-operation in the same admission was required in 3 patients (1.9%). Conclusions. In this review trans vesical prostatectomy was found to have good long-term outcome and a low rate of complications. Its success has a durable effect and only rarely was a corrective procedure necessary. This approach should be included in the list of possible treatments to discuss with the patient with a large prostate and in a set up where endoscopic instrument not available.