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Amu OC, Affusim EA, Nnadozie UU, Nwachukwu CD. Outcome of transurethral resection of the prostate (TURP) using 5% dextrose water as irrigant. Niger J Clin Pract 2023; 26:1568-1574. [PMID: 37929537 DOI: 10.4103/njcp.njcp_278_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
Background TURP remains the gold standard for simple prostatectomy presently. Different fluids have been used for irrigation while performing monopolar TURP. The choice of irrigation fluid depends on a lot of factors. Aim We sought to find out if the outcome of monopolar TURP using 5% dextrose water in our setting compares with findings in other studies using different fluids as irrigation fluid in monopolar TURP. Materials and Methods This was a prospective study of 220 patients who had monopolar TURP using 5% dextrose water as irrigation fluid from 2015 to 2020. Results The study was completed by 220 patients. The mean age was 66.25 yrs. The mean weight of prostate was 53.2 g, and mean resected weight was 30.10 g using a mean irrigation volume of 45.35 liters, 5% dextrose water over a mean resection time of 66.08 mins. The mean changes in International Prostate Symptom Score/quality of life score (IPSS/QOLS) were statistically significant. Early complications recorded were postoperative hematuria with clot retention (1.4%), urinary tract infection (UTI) (13.2%), and secondary hemorrhage (10%). TURP syndrome was not recorded. Late complications seen within 2 years follow-up were transient urinary incontinence (6.4%), urethral stricture (4.1%), and bladder neck contracture (2.3%). There was no repeat TURP for residual adenoma within this period. Conclusion TURP using 5% dextrose water has comparable outcomes to other irrigation fluids for monopolar TURP. It is a good alternative to any other irrigation fluid.
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Affiliation(s)
- O C Amu
- Department of Surgery, College of Medicine, University of Nigeria, Enugu Campus, Nigeria
| | - E A Affusim
- Department of Surgery, College of Medicine, Odumegwu Ojukwu University Awka, Anambra, Nigeria
| | - U U Nnadozie
- Department of Surgery, Federal University Teaching Hospital, Abakiliki, Ebonyi, Nigeria
| | - C D Nwachukwu
- Department of Surgery, University of Nigeria Teaching Hospital, Enugu, Nigeria
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Zubair A, Davis S, Balogun DI, Nwokeocha E, Chiedozie CA, Jesuyajolu D. A Scoping Review of the Management of Benign Prostate Hyperplasia in Africa. Cureus 2022; 14:e31135. [PMID: 36349068 PMCID: PMC9637021 DOI: 10.7759/cureus.31135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2022] [Indexed: 11/08/2022] Open
Abstract
Benign prostatic hyperplasia (BPH) is a non-malignant prostate gland enlargement of unknown cause that affects more than 50% of men over 60 and is the most common cause of bladder outlet obstruction and voiding symptoms. BPH is treated primarily with watchful waiting, phytotherapy (herbs), and medical or surgical options. In this study, we sought to examine the different management practices in African urological centers, outcomes of management, and complications. A literature search was conducted using PubMed, African Journal Online, and Google Scholar regarding the management of BPH from inception till date. Articles were selected based on their relevance to the management of benign prostatic enlargement in Africa. Results are reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews. The studies included were conducted from 1997 to 2022. They were from eight different African countries (Nigeria, Kenya, Togo, Ethiopia, Egypt, South Africa, Ghana, and Congo), with Nigeria contributing the most with 10 studies. Exactly 2999 patients were included in the study. Seventy-three (73.49%) percent of these patients totaling 2204, underwent surgical management of BPH, 124 (4.13%) patients were treated with phytomedicines or herbs, and 684 (22.80%) patients were treated with medical therapy. The complications and outcomes were studied and collated. A total of 808 patients opted for non-surgical treatment for BPH in the included studies. In this group, 124 were treated using phytochemicals or natural herbs, and 648 were treated with standard prescription medications. While surgical treatment for benign prostatic enlargement is shifting towards minimally invasive procedures in the developed world, open prostatectomy is still quite popular in Africa. Further research should focus not only on the reason for these disparities in management but also on the rationale for the selection of medical, surgical, or phytotherapy in African urological centres.
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Manfredi C, García-Gómez B, Arcaniolo D, García-Rojo E, Crocerossa F, Autorino R, Gratzke C, De Sio M, Romero-Otero J. Impact of Surgery for Benign Prostatic Hyperplasia on Sexual Function: A Systematic Review and Meta-analysis of Erectile Function and Ejaculatory Function. Eur Urol Focus 2022; 8:1711-1732. [PMID: 35803852 DOI: 10.1016/j.euf.2022.06.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 06/17/2022] [Indexed: 01/25/2023]
Abstract
CONTEXT Several sexual side effects, including erectile, ejaculatory, and orgasmic dysfunction, were reported with the majority of surgical procedures for benign prostatic obstruction (BPO). OBJECTIVE To systematically review current evidence regarding the impact of benign prostatic hyperplasia (BPH) surgery on sexual function. EVIDENCE ACQUISITION A comprehensive bibliographic search on the MEDLINE, Cochrane Library, Embase, Web of Science, and Google Scholar databases was conducted in July 2021. The population, intervention, comparator, and outcome (PICO) model was used to define study eligibility. Studies were Included if they assessed patients with BPO and related lower urinary tract symptoms (P) undergoing BPH surgery (I) with or without a comparison between surgical treatments (C) evaluating the impact on sexual function (O). Retrospective and prospective primary studies were included. A pooled analysis was conducted on studies including the postoperative assessment of International Index of Erectile Function (IIEF)-5, Male Sexual Health Questionnaire-Ejaculatory Dysfunction (MSHQ-EjD; Function and/or Bother), or retrograde ejaculation (RE) rate (PROSPERO database ID: CRD42020177907). EVIDENCE SYNTHESIS A total of 151 studies investigating 20 531 patients were included. Forty-eight randomized controlled trials evaluating 5045 individuals were eligible for the meta-analysis. In most studies (122, 80.8%), only erectile and/or ejaculatory function was evaluated. A substantial number of articles (67, 44.4%) also used nonvalidated tools to evaluate erectile and/or ejaculatory function. The pooled analysis showed no statistically significant changes in IIEF-5 score compared with baseline for the transurethral resection of the prostate (TURP; weighted mean difference [WMD] 0.76 pts; 95% confidence interval [CI] -0.1, 1.62; p = 0.08), laser procedure (WMD 0.33 pts; 95% CI -0.1, 0.77; p = 0.13), and minimally invasive treatment (WMD -1.37 pts; 95% CI -3.19, 0.44; p = 0.14) groups. A statistically significantly higher rate of RE was found after TURP (risk ratio [RR] 13.31; 95% CI 8.37, 21.17; p < 0.00001), other electrosurgical procedures (RR 34.77; 95% CI 10.58, 127.82; p < 0.00001), and the entire laser group (RR 17.37; 95% CI 5.93, 50.81; p < 0.00001). No statistically significant increase in RE rate was described after most of the minimally invasive procedures (p > 0.05). The pooled analysis of MSHQ-EjD scores was possible only for prostatic urethral lift, showing no statistically significant difference between baseline and post-treatment MSHQ-EjD Function scores (WMD -0.80 pts; 95% CI -2.41, 0.81; p = 0.33), but postoperative MSHQ-EjD Bother scores were significantly higher (WMD 0.76 pts; 95% CI 0.22, 1.30; p = 0.006). CONCLUSIONS Erectile function appears to be unaffected by most surgical procedures for BPO. RE is a very common adverse event of BPH surgery, although emerging minimally invasive surgical procedures could be associated with a lower risk. PATIENT SUMMARY Benign prostatic hyperplasia surgery can have an impact on sexual function, mainly involving ejaculatory function.
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Affiliation(s)
- Celeste Manfredi
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Borja García-Gómez
- Department of Urology, Hospital Universitario 12 Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain; Department of Urology, HM Hospitales (Montepríncipe, Puerta del Sur, Sanchinarro), Madrid, Spain; ROC Clinic, Madrid, Spain
| | - Davide Arcaniolo
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Esther García-Rojo
- Department of Urology, HM Hospitales (Montepríncipe, Puerta del Sur, Sanchinarro), Madrid, Spain; ROC Clinic, Madrid, Spain
| | - Fabio Crocerossa
- Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Riccardo Autorino
- Division of Urology, Virginia Commonwealth University, Richmond, VA, USA
| | - Christian Gratzke
- Department of Urology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Marco De Sio
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Javier Romero-Otero
- Department of Urology, HM Hospitales (Montepríncipe, Puerta del Sur, Sanchinarro), Madrid, Spain; ROC Clinic, Madrid, Spain.
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Mannem S, Mallikarjuna C, Bhavatej E, Taif NBM, Ravichander O, Syed MG. Incidence of urethral stricture following bipolar transurethral resection of prostate: A single-center study. Indian J Urol 2022; 38:146-150. [PMID: 35400870 PMCID: PMC8992716 DOI: 10.4103/iju.iju_228_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 12/30/2021] [Accepted: 02/09/2022] [Indexed: 11/04/2022] Open
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Omenai SA, Fashola OA, Takure AO, Ogunbiyi JO. Incidental Prostatic Adenocarcinoma in Open Prostatectomy Specimens: An Institutional Experience. Niger Med J 2021; 62:298-304. [PMID: 38736511 PMCID: PMC11087685 DOI: 10.60787/nmj-62-6-59] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024] Open
Abstract
Background Prostatic diseases cause significant morbidity and mortality in African men. Most Nigerian patients presenting with huge prostate enlargement are availed open prostatectomy to relieve symptoms of prostatism. Some prostates removed for benign enlargement have indolent cancers that are only discovered after histopathological examination. The incidence of these incidental adenocarcinomas of the prostate varies widely. Methodology We carried out a 10-year retrospective review of open prostatectomy specimens received in the Department of Pathology, from January 2009 to December 2018. At grossing, a minimum of 6 cassettes were used depending on size, and tissue was taken from representative areas for microscopic examination. The data was analysed for the presence of, and the relationship between, incidental adenocarcinoma of the prostate and clinicopathological parameters in each case using relevant statistical tools in the SPSS version 23. Results Incidental adenocarcinoma of the prostate was found in 5.7% of 158 open prostatectomy specimens seen during the study period. High-grade prostatic intraepithelial neoplasm (HGPIN) was present in 1.9% of cases. Patients in the 7th and 8th decade accounted for 88.8% of all incidental adenocarcinomas. The mean weight of the excised glands was 89.8g (range10-500g). The weight of the prostate did not predict diagnosis of incidental adenocarcinoma. In-hospital consultation accounted for 66.9% of open prostatectomy samples received in the department but the majority (72.7%) of incidental adenocarcinomas were seen in specimens form external consultations. The tumours were mostly ISUP grade group one tumours. Conclusion The rate of diagnosis of occult prostate cancer is low with majority of the tumours being well differentiated. Organ weight had no relationship with histological diagnosis. Cases managed outside the teaching hospital were more likely to have incidental prostate cancer.
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Affiliation(s)
| | | | | | - John Olufemi Ogunbiyi
- Department of Pathology, University College Hospital, Ibadan, Nigeria
- Department of Pathology, College of Medicine, University of Ibadan, Nigeria
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Jeje EA, Alabi TO, Ojewola RW, Ogunjimi MA, Tijani KH, Asiyanbi GK. Monopolar transurethral resection of the prostate using water as the irrigation fluid: Our initial experience. Niger Postgrad Med J 2021; 28:175-180. [PMID: 34708703 DOI: 10.4103/npmj.npmj_502_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Monopolar transurethral resection of the prostate (M-TURP) has been the gold standard of surgical intervention in patients with benign prostatic hyperplasia with the indication for surgery. This can be achieved using varieties of irrigation fluids. Objectives To document our experience with M-TURP using water as irrigation fluid in 123 consecutive patients. Materials and Methods A retrospective study of all patients who had M-TURP with water as irrigation fluid was performed between January 2017 and July 2019. Information retrieved from theatre records and case notes includes patient's socio-demographic data, indications for surgery, intra-operative findings, the volume of resected chips and irrigation fluid used, post-operative complications and patient's satisfaction with the outcome of the procedure. These data were analysed using SPSS version 23. Results Data from 123 patients were analysed and presented. The age range was 44-96 years with a mean of 69 years. Prostate volume ranges from 13.9 to 276.00 mls with a mean of 95.69 mls while resected prostate volume ranges from 2.0 to 158.0 mls with a mean of 56.68 mls. Volume of the sterile water used as irrigation fluid ranged from 5.0 L to 174.0 L with a mean of 68.7 L. Mean reduction in International Prostate Symptoms Score, improvement in Q-max and reduction in post-void residual urine were 22.1, 16.9 and 141.6 mls, respectively. Transfusion rate was 6.5% while the duration of admission ranges from 1 to 6 days, with a mean of 2.5 days. The overall complication rate was 26.0%. Ninety-six percent were satisfied with the outcome. Conclusion M-TURP using water as irrigation fluid is safe and is as good as using the more rather expensive glycine or normal saline in bipolar TURP.
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Affiliation(s)
- Emmanuel A Jeje
- Department of Surgery, College of Medicine of University of Lagos, Idi-Araba, Lagos, Nigeria / Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
| | - Taiwo O Alabi
- Department of Surgery, Urology Unit, Federal Medical Centre, Lagos, Nigeria
| | - Rufus W Ojewola
- Department of Surgery, College of Medicine of University of Lagos, Idi-Araba, Lagos, Nigeria / Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
| | - Moses A Ogunjimi
- Department of Surgery, College of Medicine of University of Lagos, Idi-Araba, Lagos, Nigeria / Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
| | - Kehinde H Tijani
- Department of Surgery, College of Medicine of University of Lagos, Idi-Araba, Lagos, Nigeria / Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
| | - Gabriel K Asiyanbi
- Anaesthesia, College of Medicine of University of Lagos, Idi-Araba, Lagos, Nigeria / Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
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Ofoha CG, Raphael JE, Dakum NK, Shu'aibu SI, Akhaine J, Yaki IM. Surgical management of benign prostate hyperplasia in Nigeria: open prostatectomy versus transurethral resection of the prostate. Pan Afr Med J 2021; 39:165. [PMID: 34539961 PMCID: PMC8434791 DOI: 10.11604/pamj.2021.39.165.24767] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 06/26/2021] [Indexed: 11/12/2022] Open
Abstract
Introduction transvesical (open) prostatectomy (OP), an invasive surgical procedure, is a common form of treatment offered to patients with benign prostatic enlargement in emerging economies. Recently, there has been an increase in the use of electrosurgical means in treating benign prostate hyperplasia in our environment, especially transurethral resection of the prostate (TURP). This study compares the perioperative, short-term outcomes and complications of open prostatectomy and TURP. Methods the records of men who had prostatectomies (OP and TURP) from Jan 2016 to Dec 2019 for prostate gland less than 80g were reviewed. The patients´ age, size of the prostate gland, duration of surgery (mins), blood transfusion, clot retention, length of catheterisation (days), hospital stay (days), postoperative infection, postoperative incontinence, reoperation, bladder neck stenosis and urethral stricture were analysed. Results fifty-nine patients were studied. Twenty-nine patients had OP, while 30 had TURP. Mean age for OP was 63.8 (SD 7.2) years, while for TURP is 68.5 (SD 8.0) years (p=0.019). The mean for length of catheterisation for OP vs TURP was 9.1 (SD 3.7) vs 3.3 (SD 1.03) days (p=0.001), mean hospital stay was 9.6 (SD 4.1) and 4.7 (SD 2.2) days (p=0.001) for OP and TURP while duration of surgery (mins) for OP and TURP was 106.7 (SD 15.2) vs 53.8 (SD 14.0) minutes (p=0.001). The blood transfusion rate was 13.8% and postoperative incontinence 13.8% in OP, while in the TURP group, the reoperation rate was 3.3% and urethral stricture at a rate of 3.3%. Overall complications showed no statistical difference (p=0.462) between the two groups. Conclusion the patients who underwent TURP had shorter hospital stay, shorter duration of surgery and catheterisation, and less frequently required blood transfusion compared to those who had open prostatectomy. However, reoperation rate was higher compared to open prostatectomy. The overall complication was fewer with TURP, but this is not statistically significant; hence both forms of surgical therapy remain relevant in a poor resource setting.
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Affiliation(s)
- Chimaobi Gideon Ofoha
- Department of Surgery, Jos University Teaching Hospital (JUTH), Jos, Nigeria.,College of Health Sciences, University of Jos, Jos, Nigeria
| | - John Edoka Raphael
- Department of Surgery, College of Health Sciences, University of PortHarcourt, PortHarcourt, Nigeria.,Department of Urology, University of PortHarcourt Teaching Hospital, PortHarcourt, Nigeria
| | - Nuhu Kutan Dakum
- Department of Surgery, Jos University Teaching Hospital (JUTH), Jos, Nigeria.,College of Health Sciences, University of Jos, Jos, Nigeria
| | - Samaila Ibrahim Shu'aibu
- Department of Surgery, Jos University Teaching Hospital (JUTH), Jos, Nigeria.,College of Health Sciences, University of Jos, Jos, Nigeria
| | - Julius Akhaine
- Department of Surgery, Jos University Teaching Hospital (JUTH), Jos, Nigeria
| | - Isaac Musa Yaki
- Department of Surgery, Jos University Teaching Hospital (JUTH), Jos, Nigeria
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8
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Mbaeri TU, Abiahu JA, Obiesie EA, Odo C, Oranusi KC, Nwofor AME, Orakwe JC. Assessment of Complications of Transurethral Resection of the Prostate Using Clavien-Dindo Classification in South Eastern Nigeria. Niger J Surg 2020; 26:142-146. [PMID: 33223813 PMCID: PMC7659755 DOI: 10.4103/njs.njs_20_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 05/06/2020] [Accepted: 06/04/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Benign prostatic hyperplasia is one of the most common diseases in aging males. For men that need surgical treatment, transurethral resection of the prostate (TURP) is the gold standard. The aim of this article is to retrospectively review the complications of TURP over a 3-year period in Nnamdi Azikiwe University Teaching Hospital Nnewi and a Specialist Urology Center in Awka all in Anambra South-East Nigeria using Clavien-Dindo classification. Patients and Methods: The study was a retrospective review of consecutive TURPs done over a 3-year period. Patients' information and complications arising from the procedure were collected and graded using the Clavien-Dindo classification with a pro forma designed for the study and analyzed with the Statistical Package for the Social Sciences software version 20.0. Results: Ninety-seven patients had TURP during the period of this study. Twenty-nine complications were noted in 24 patients. The postoperative morbidity rate was 24.74%, and no mortality was recorded. Most of the complications were grade 2 (55%), followed by grade 1 and 3 (20.69%) each. Grade 4a complication accounted for only 3.45%. No grade 5 complication was recorded. Conclusion: TURP is safe, with minimal life-threatening morbidity even in a resource-poor economy where TURP is gradually gaining grounds.
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Affiliation(s)
- Timothy Uzoma Mbaeri
- Department of Surgery, Nnamdi Azikiwe University, Nnewi Campus, Anambra State, Nigeria
| | - Joseph Amauzo Abiahu
- Department of Surgery, Nnamdi Azikiwe University, Nnewi Campus, Anambra State, Nigeria
| | | | - Chinonso Odo
- Department of Surgery, Nnamdi Azikiwe University, Nnewi Campus, Anambra State, Nigeria
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Salako AA, Badmus TA, Onyia CU, David RA, Adejare IE, Lawal AO, Onyeze CI, Ndegbu CU. An audit of surgical site infection following open prostatectomy in a Nigerian Teaching Hospital. Afr Health Sci 2019; 19:2068-2072. [PMID: 31656490 PMCID: PMC6794519 DOI: 10.4314/ahs.v19i2.30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Surgical site infections (SSI) are a potential cause of morbidity and increased cost of care after operations such as open prostatectomy. Objective To audit the occurrence of SSI after open prostatectomy at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Nigeria Methods A review of all patients who underwent open prostatectomy over a ten-year period (July 2005 to June 2015). Data analysis was done using the statistical package for social sciences version 21. Association between variables was determined using Chi-square or Fisher's exact test as appropriate. A p-value < 0.05 was considered statistically significant. Results A total of 247 open prostatectomy surgeries were reviewed, with the patients' ages ranging from 43 – 91 years and a mean age of 67.0 ± 8.8 years. Elective procedures were 98.8% while the remaining 1.2% were emergency cases. There were 24 (9.8%) surgical site infections. The duration of admission of the patients with SSI ranged from 6 – 15 days with a mean of 9.5 ± 3.2 days, as against 4 – 9 days (mean of 5.0 ± 2.1days) for those without SSI. All the patients with SSI were successfully managed with no resultant mortality. Risk factors identified for SSI were emergency surgery (p=0.001), obesity (p<0.0001), diabetes mellitus (p=0.008), smoking (p<0.0001), pre-operative catheterization (p<0.0001), excessive haemorrhage (p<0.0001) and post-operative suprapubic bladder drainage (p<0.0001). Conclusion SSI is a recognized complication of open prostatectomy. Identified risk factors for its occurrence from this audit are emergency operation, obesity, diabetes mellitus, smoking, pre-operative catheterization, excessive haemorrhage and post-operative suprapubic bladder drainage. Age, approach to prostatectomy (retropubic vs transvesical), incision type (lower midline vs pfannenstiel), level of the surgeon, catheter type and modality of irrigation were however not significant risk factors for post-prostatectomy SSI in this study.
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Affiliation(s)
- Abdulkadir A Salako
- Department of Surgery, Obafemi Awolowo University, Ile-Ife, Nigeria
- Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | - Tajudeen A Badmus
- Department of Surgery, Obafemi Awolowo University, Ile-Ife, Nigeria
- Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | - Chiazor U Onyia
- Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | - Rotimi A David
- Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | | | | | - Chigozie I Onyeze
- Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | - Chinedu U Ndegbu
- Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
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10
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Tao H, Jiang YY, Jun Q, Ding X, Jian DL, Jie D, Ping ZY. Analysis of risk factors leading to postoperative urethral stricture and bladder neck contracture following transurethral resection of prostate. Int Braz J Urol 2017; 42:302-11. [PMID: 27256185 PMCID: PMC4871391 DOI: 10.1590/s1677-5538.ibju.2014.0500] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 05/04/2015] [Indexed: 02/20/2024] Open
Abstract
Purpose: To determine risk factors of postoperative urethral stricture (US) and vesical neck contracture (BNC) after transurethral resection of prostate (TURP) from perioperative parameters. Materials and Methods: 373 patients underwent TURP in a Chinese center for lower urinary tract symptoms suggestive of benign prostatic obstruction (LUTS/BPO), with their perioperative and follow-up clinical data being collected. Univariate analyses were used to determine variables which had correlation with the incidence of US and BNC before logistic regression being applied to find out independent risk factors. Results: The median follow-up was 29.3 months with the incidence of US and BNC being 7.8% and 5.4% respectively. Resection speed, reduction in hemoglobin (ΔHb) and hematocrit (ΔHCT) levels, incidence of urethral mucosa rupture, re-catheterization and continuous infection had significant correlation with US, while PSA level, storage score, total prostate volume (TPV), transitional zone volume (TZV), transitional zone index (TZI), resection time and resected gland weight had significant correlation with BNC. Lower resection speed (OR=0.48), urethral mucosa rupture (OR=2.44) and continuous infection (OR=1.49) as well as higher storage score (OR=2.51) and lower TPV (OR=0.15) were found to be the independent risk factors of US and BNC respectively. Conclusions: Lower resection speed, intraoperative urethral mucosa rupture and postoperative continuous infection were associated with a higher risk of US while severer storage phase symptom and smaller prostate size were associated with a higher risk of BNC after TURP.
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Affiliation(s)
- Huang Tao
- Department of Urology, Anhui Provincial Hospital,Hefei, Anhui, China
| | - Yu Yong Jiang
- Department of Urology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qi Jun
- Department of Urology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xu Ding
- Department of Urology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Duan Liu Jian
- Department of Urology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ding Jie
- Department of Urology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhu Yu Ping
- Department of Urology, Anhui Provincial Hospital,Hefei, Anhui, China
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11
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Ajape AA, Kuranga SA, Babata A, Kura MM, Bello JO. An appraisal of a technical modification for prevention of bladder neck stenosis in retropubic prostatectomy: An initial report. Urol Ann 2016; 8:1-5. [PMID: 26834392 PMCID: PMC4719497 DOI: 10.4103/0974-7796.163799] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective: To report the experience with our technical modification of the trigone-bladder neck complex management in the prevention of bladder neck stenosis (BNS) following open simple retropubic prostatectomy. Materials and Methods: It was a retrospective review of data of patients that underwent open simple retropubic prostatectomy with technical modification of the trigone-bladder neck complex in two Nigerian tertiary hospitals, by a single surgeon, from January 2007 to December 2011. The data analysed included the demographic variables, the modes of presentation, need for blood transfusion, duration of catheterization and the duration of hospital stay. The primary end-point was the development or otherwise of BNS. Results: Eighty-seven patients’ data were available for analysis from a total of 91 patients. The mean age (±standard deviation [SD]) was 65.14 years (±10.55). Preoperative urinary retention was present in 58% of the patients. The maximal flow rate (Qmax) was 12.05 ml/s among the 20 patients that had preoperative uroflowmetry. The transfusion rate was 35%, but almost two-third of them had only one unit of blood transfused. The mean weight (±SD) of the enucleated adenoma was 82.64 g (±36.63). Bladder irrigation was required in 14% of the patients, majority of the patients had urethral catheter removed after 96 h and the mean hospital stay was 6.52 days. No patient developed BNS after a mean follow-up duration of 16.39 months. Conclusion: Bladder neck stenosis can be a distressing complication of prostatectomy. The result of our technical modification of managing the trigone-bladder-neck complex looks promising for prevention or delaying the onset of BNS. A long-term observation and a prospective randomised control trial to ascertain this initial experience is needed.
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Affiliation(s)
| | | | - AbdulLateef Babata
- Department of Surgery, Division of Urology, University of Ilorin, Ilorin, Nigeria
| | | | - Jibril O Bello
- Department of Surgery, Division of Urology, University of Ilorin Teaching Hospital, Ilorin, Nigeria
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Validation of supra-pubic ultrasonography for preoperative prostate volume measurement in sub-Saharan Africa. Int Urol Nephrol 2010; 43:283-8. [DOI: 10.1007/s11255-010-9844-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2010] [Accepted: 08/31/2010] [Indexed: 10/19/2022]
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13
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Takure AO, Onuora VC, Akerele W. Post open prostatectomy bladder exteriorization mimicking "acquired bladder extrophy". Open Access J Urol 2010; 2:31-4. [PMID: 24198611 PMCID: PMC3818875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A 58-year-old Nigerian male had open prostatectomy undertaken in a private hospital 3 months before presenting at our out-patient clinic with leakage of urine and a widening supra pubic defect of 10 weeks duration. Examination showed the posterior bladder wall and visible trigone. Subsequently the defect was closed and he remained continent at follow up.
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Affiliation(s)
- AO Takure
- Urology Division, Department of Surgery, University College Hospital, Ibadan, Nigeria,Correspondence: AO Takure, Urology Division, Department of Surgery, University College Hospital, Ibadan, Nigeria, Email
| | - VC Onuora
- College of Health Sciences, Igbinedion University, Okada, Benin, Nigeria
| | - W Akerele
- Urology Unit, Department of Surgery, Irrua Specialist Teaching Hospital, Irrua, Nigeria
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Gavaza P, Rascati KL, Oladapo AO, Khoza S. The state of health economic evaluation research in Nigeria: a systematic review. PHARMACOECONOMICS 2010; 28:539-53. [PMID: 20550221 DOI: 10.2165/11536170-000000000-00000] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
This study assessed the state of health economic evaluation (including pharmacoeconomic) research in Nigeria. A literature search was conducted to identify health economic articles pertaining to Nigeria. Two reviewers independently scored each article in the final sample using a data collection form designed for the study. A total of 44 studies investigating a wide variety of diseases were included in the review. These articles were published in 34 different journals, mostly based outside of Nigeria, between 1988 and 2009. On average, each article was written by four authors. Most first authors had medical/clinical affiliations and resided in Nigeria at the time of publication of the study. Based on a 1 to 10 scale, with 10 indicating the highest quality, the mean quality score for all studies was 7.29 (SD 1.21) and 59% of the articles were of fair quality (score 5-7); 5% were of even lower quality. The quality of articles was statistically significantly (p < or = 0.05) related to the country of residence of the primary author (non-Nigeria = higher), country of the journal (non-Nigeria = higher), primary objective of the study (economic analysis = higher) and type of economic analysis conducted (economic evaluations higher than cost studies). The conduct of health economic (including pharmacoeconomic) research in Nigeria was limited and about two-thirds of published articles were of sub-optimal quality. More and better quality health economic research in Nigeria is warranted.
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Affiliation(s)
- Paul Gavaza
- College of Pharmacy, The University of Texas at Austin, Austin, Texas, USA.
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