Early outcomes of prostatectomy for benign prostatic enlargement at Moi Teaching and Referral Hospital, Eldoret, Kenya

Abstract

Background: Prostatectomy is the main treatment option for patients with moderate to severe symptoms due to benign prostatic enlargement (BPE). The early outcomes following prostatectomy are results from intraoperative up to thirty days post discharge. There is paucity of data especially on factors that influence the early outcomes of prostatectomy. Objective: To describe the early outcomes and factors that influence them following prostatectomy for benign prostatic enlargement at MTRH. Methods: A prospective descriptive study was conducted from December 2018 to December 2019 after approval from the Institutional Research and Ethics Committee. Fifty-six patients were recruited into the study. Socio-demographic and clinical characteristics were obtained using an interviewer-administered questionnaire. Primary outcome measure was type of prostatectomy while blood transfusion rate, wound infection, length of stay and mortality were secondary outcome measures. Demographic and clinical data was analyzed for mean, median and percentages and presented in tables and graphs. Chi-square and Fisher’s exact tests was used to assess association between variables. Analysis was carried out at 95% level of confidence and an alpha of 0.05 for statistical significance. Results: The age ranged between 51 and 89 years with a mean of 70.9 years ± SD 9.3.The patients who underwent open prostatectomy (OP) were 83.9% while the rest underwent TURP. For those who underwent OP, 61.7% had Freyer’s while 38.3% had Millin’s procedure. The mean length of hospital stay was 8 days in OP and 4 days in TURP. The patients transfused were 14.9%, and all had undergone open prostatectomy. The rate of wound infection prostatectomy was 8.5% and was only in those with open prostatectomy. There was no post-operative mortality. Hypertension was the most common comorbidity at 67.6%. Presence of comorbidity and amount of blood loss were significantly associated with blood transfusion (p=0.019, 0.002). No factor was significantly associated with wound infection Conclusion: Open prostatectomy has worse surgical outcomes than TURP. Comorbidities influence the outcomes following prostatectomies Recommendations: Pre-operative evaluation for comorbidities and subsequent stabilization of patients should be emphasized to improve on outcomes of prostatectomies in MTRH.