SUPRAPUBIC TRANSVESICAL PROSTATECTOMY IN A RURAL KENYAN HOSPITAL

Abstract

Objective: To evaluate the effectiveness, safety and complications of suprapubic transvesical
prostatectomy in a rural Kenyan hospital.
Design: A prospective audit of suprapubic transvesical prostatectomy.
Setting: Africa Inland Church, Kijabe Hospital, Kijabe, Kenya.
Subjects: One hundred and six men with lower urinary tract obstruction, clinically due to
benign prostatic hyperplasia, undergoing suprapubic transvesical prostatectomy.
Interventions: Suprapubic prostatectomy.
Main outcome measures: Age, presentation, comorbidity, type of anaesthesia, pathology,
bladder irrigation time, Foley time, post-operative stay, complications-mortality, blood
transfusion rate, return to theatre for bleeding, incontinence, urine leak, urinary retention.
Results: One hundred and six men entered the study with a mean age of 72.8 years. Seventy
eight per cent were in retention and 25% had significant medical problems. Spinal anaesthesia
was used in 94%. The mean prostate weight was 70.4g and 11% had carcinoma. The Foley's
catheter was removed at a mean of 4.2 days after surgery and the mean post-operative stay
was 6.0 days. The 30 day mortality was 0.9%, the blood transfusion rate was 4.7%, the return
to theatre for bleeding rate was 0.9% and 4.7% of patients developed a urine leak.
Conclusion: Suprapubic transvesical prostatectomy, performed under spinal anaesthetic,
by general surgeons in rural Kenya, is a safe and effective way of managing benign prostatic
hyperplasia and its complications.