Long Term Outcomes of Trans Vesical Prostatectomy for Benign Prostatic Hyperplasia

Long Term Outcomes of Trans Vesical Prostatectomy for Benign Prostatic Hyperplasia | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Long Term Outcomes of Trans Vesical Prostatectomy for Benign Prostatic Hyperplasia Wondewosen Lette, Fasil Wale This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5940883/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract 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. Trans Vesical Prostatectomy Benign Prostatic Hyperplasia (BPH) Open Prostatectomy Lower Urinary Tract Symptoms (LUTS) Long-term Outcomes Symptom Improvement Postoperative Complications Retrospective Study Urethral Stricture Urinary Incontinence Surgical Outcomes Developing Countries Ethiopia Figures Figure 1 Figure 2 Figure 3 Introduction Benign Prostatic hyperplasia (BPH) is the commonest cause of urinary problems in elderly males affecting the quality of life[ 1 ]. Urinary retention due to prostatic disease is a major geriatric problem[ 2 ]. Modalities of treatment include watchful waiting, medical treatment like alpha blockers and 5-@ reductase inhibitor for mild to moderate symptoms and surgical treatment like TUIP, TURP, open prostatectomy, etc.[ 2 ]. Trans vesical prostatectomy (TVP) is a popular type of open prostatectomy; however, the application of TVP for large prostates has been progressively decreasing over the years with the advent of minimally invasive techniques, including monopolar and bipolar TURP, photoselective vaporization techniques, different laser therapies, etc.[ 3 ]. Currently, TURP is considered as the reference or standard treatment for the prostate less than 70 to 80 g[ 4 ]. However open prostatectomy is still being performed for operations of the prostates that are candidate for TURP in many developing countries especially in Africa partly due to poor availability of endoscopic equipment & scarcity of trained endoscopic personnel[ 5 ]. The aim of this study was to provide information about the long-term efficacy of trans vesical prostatectomy from a contemporary series of patients. Methods and Materials From January 2019 to December 2020, 212 patients underwent open trans vesical prostatectomy in the three hospitals. The indications for surgical management were urinary retention and other complications and/or bothersome lower urinary tract symptoms (LUTS) attributed to BPH. Fifty patients with lost follow up chart and incomplete follow up data were excluded from the study. Another two patient with post operative biopsy result indicating prostatic cancer and pre operative cystoscopy showing urethral stricture were excluded from the study. The final study group included 160 patients who underwent open trans vesical prostatectomy. All the data were analyzed by the same investigator to ensure strict inclusion criteria. Consent for the study was obtained from the hospital ethical committee and submitted to the respective hospital administrator. Data collection tools were prepared as semi structured check list and categorized as sociodemographic, pre operative, intra operative and post operative data. Intra operative complications were defined as complications occurring at the time of surgery; early when within the first 30 days after surgery; and late when beyond 30 days after surgery. Ethical considerations Ethics Approval Statement: Ethical clearance for the study was obtained from the Institutional Health Ethics Review Committee of the College of Health and Medical Sciences, Addis Ababa University, in accordance with national ethical guidelines and the university's commitment to research ethics. The research was conducted in compliance with the Helsinki Declaration and in accordance with the relevant guidelines. Prior to data collection, an official letter was obtained from the College and submitted to the responsible authorities to ensure compliance with institutional protocols. Consent to Participate Statement: Informed consent was obtained from all study participants before their inclusion in the study. To ensure confidentiality, no patient names were recorded in the data collection format. Additionally, patient cards were returned to the card room immediately after data collection was completed, adhering to ethical norms for data security and patient privacy. Results Socio-demographic and pre-operative results The mean age of the patient was 67.39years (range from 45 to 96years) with SD 9.298. Majority of the patients were from Addis Ababa (80%) followed by Oromia region (12.5%), Amhara (4.4%) and Southern Nation (3.1%). Around 54 (33.75%) patients had minimum of one comorbidity, HTN found in 34(21.3%), DM in 5(3.1%), coexistence of hypertension and DM in 8(5%), cardiac and asthma in 3 patients each; and RVI in one. Preoperative U/A or urine culture was done for 115 patients and of these 43(37.4%) of them has result suggestive of UTI and they were treated before or following the surgery. Cystoscopy was done for 61(38.1%) patients for an indication of hematuria history, to assess the size of prostate and to rule out urethral stricture. Table 1 Pre operative U/A or urine culture Frequency Percent Valid Percent Cumulative Percent Valid U/A not done 45 28.1 28.1 28.1 U/A shows None Revealing 69 43.1 43.1 71.3 U/A shows UTI 39 24.4 24.4 95.6 Urine Culture shows no growth 3 1.9 1.9 97.5 Urine culture shows growth 4 2.5 2.5 100.0 Total 160 100.0 100.0 Table 2 , Patients’ peri-operative data N Minimum Maximum Mean Std. Deviation Duration of catheterization in weeks 96 1 50 6.75 6.344 Prostate volume (in CC) by Abdominopelvic Ultrasound 158 29 287 96.54 46.602 Size of transurethral catheter 152 16 24 21.80 1.764 Trans urethral catheter balloon inflated in cc 150 20.00 80.00 35.0333 9.89028 Duration of post op catheterization 159 6 69 11.40 7.839 Duration of hospital stay before surgery 160 1 30 3.09 3.470 Duration of hospital stay after surgery 160 2 27 4.84 3.071 Valid N (listwise) 89 All patients presented with LUTS of 2 months to > 10 years duration, majority being in 1-2years 62(38.8%) followed by 2–5 years 49(30.6%) and < 6months 20(12.5%). One hundred thirty-three patients (83.1%) presented with complaints of severe urinary symptoms the rest with moderate 11(6.9%) and moderate to severe 16(10%) LUTS. Ninety-six (60%) of them had been catheterized preoperatively due to urinary retention, AUR 86(53.8%) & CUR 10(6.3%) for a mean duration of catheterization of 6.75weeks (range of 1–50 weeks). The most common indication of TVP was recurrent AUR 84(52.5%) followed by bothersome LUTS 52(32.5%), failed medical therapy 10(6.3%), CUR 9(5.6%), hematuria (4) and recurrent UTI (1). The average size of prostate by preoperative trans abdominal ultrasound estimation was found to be 96.54 ranging from 29cc- 287cc, SD = 46.6. Perioperative data results One hundred thirty-five (84.4%) of patient were operated under spinal anesthesia (SA) followed by SA + sedation 10(6.3), General Anesthesia 9(5.6%) and failed SA + GA 6 (3.8%). The majority of the procedure was done by year 1 urology residents 79(49.4%) followed by 2nd year urology resident 50(31.3%) and final year general surgery resident 20 (12.5%) under consultant supervision. Majority of the surgery took 60–90 minutes (53.8%) followed by > 90 minutes in 67 (41.8%) cases and < 60 minute in 7 (4.4%) patients. Intra op accident were noticed in 5 (3.1%) patients and it include prostatic capsular breach in 2 (1.2%), bowel injury in 1 and intra op hypotension and hypertension each of them 1 case. Perioperative transfusion for significant bleeding was required in 12(7.5%) patients. Table 3. Anesthetic consideration and surgeon detail The mean duration of hospital stay before surgery was 3.09 days (range 1–30 days) and after surgery 4.84 days (range 2–27 days). The mean duration of catheterization after surgery was 11.4days (ranged from 6-69days). Trial of voiding on catheter removal was failed in only 3(1.9%) patients and rest successfully voided. Table 4 Correlation between SSI, Preoperative Catheterization and Duration of Hospital Stay Duration of post operative catheterization Duration of hospital stay after surgery Wound site infection Pre operative catheterization Duration of post operative catheterization Pearson Correlation 1 .340 ** .507 ** .079 Sig. (2-tailed) .000 .000 .323 N 159 159 159 159 Duration of hospital stay after surgery Pearson Correlation .340 ** 1 .473 ** .158 * Sig. (2-tailed) .000 .000 .045 N 159 160 160 160 Wound site infection Pearson Correlation .507 ** .473 ** 1 .123 Sig. (2-tailed) .000 .000 .122 N 159 160 160 160 Pre operative catheterization Pearson Correlation .079 .158 * .123 1 Sig. (2-tailed) .323 .045 .122 N 159 160 160 160 **. Correlation is significant at the 0.01 level (2-tailed). *. Correlation is significant at the 0.05 level (2-tailed). There was significant association between preoperative catheterization and duration of hospital stay after the surgery (p- value = < 0.05) and also there was significant correlation between duration of hospital stay after surgery with duration of post operative catheterization and wound site infection (p-value = < 0.01). Results in the Early and late post-operative period About 143(89.3%)) have reported improvement in post operative LUTS at their 1st visit, 148(92.5%) at 1 month visit and 157 (98.1%) at 6th month follow up. Complication occurring in the early postoperative period were: Surgical Site Infection (SSI) 14 (8.75%), 13 of them were superficial, and vesico-cutaneous fistulae in 4 (2.5%), epididymo-orchitis in 5 patients, UTI in 8 patient and pneumonia in 2 of cases. Reoperation during the same admission was reported in 3 cases, 2 of them for bleeding and 1 patient for iatrogenic bowel injury. About 46(28.75%) patients reported some form of incontinence on their first visit and of these 3 of them reported total improvement of incontinence on their 1st month follow up. Only 12 patient reported persistence of incontinence at their 6month follow up with urge incontinence in 8 patient and stress incontinence in 4 patients. No patient with total incontinence at 6 months follow up period reported. A total of five (3.1%) patient developed urethral stricture, four on their 6th month and 1 additional patient at 1year follow up visit; and subsequently all were treated with optical urethrotomy and serial dilatation under cystoscopy guidance and bouginage. Three patient reported ED postoperatively but preoperative and post-operative sexual status was not documented for the rest of the patient. Additional outcome measures including International Prostate Symptom Score, maximal uroflowmetry rates, and postvoid residual urine were not used consistently in our cases. There was no mortality intraoperatively or in the early postoperative period. Discussion In our study the mean age of the patients was 67.4 (graph-1),similar to the study in Turkey 67.5 years (n = 664)[ 6 ] ;comparable to a mean age of 65.36 years and in a range of 69.4 ± 8.5 SD years in studies done in Nigeria (n = 362) [ 7 ]and Sudan(n = 188)[ 8 ] respectively, but lower than the study done in Germany with a mean age of 70 years (n = 201)[ 9 ]. Around 33.75% of patients had comorbidity, hypertension being the most frequent (21.3%) followed by coexisting DM & hypertension (5%); and DM (3.1%) patients (graph-2). Whereas similar study done in Turkey showed comorbidity rate of 72% ( n = 320)[ 10 ] . The most common indication in our study is recurrent AUR (52.5%), smaller than reported by Berhanu Nega(81.3%)(n = 64) in Ethiopia[ 11 ] and other similar study in Iran (60.8%)[ 12 ] ;and 66.68% by Adegun in Nigeria[ 7 ]. The mean duration of catheterization was 6.75weeks, similar to Berhanu Nega’s study (6.5 weeks). Perioperative transfusion rate in our study was 7.5%,which is lower than report in Turkey(12.7%)[ 6 ] but higher than stated by Zargooshi (3.3%) [ 12 ] and Reoperation in the same admission was needed in 3(1.9%) comparable to Zargooshi( 1%). The mean duration of hospital stay was 7.93 days (3.09 days before and 4.84 days after surgery) in the range reported by Berhanu Nega (6.94 +/- 1.7 days) but the average duration of post OP catheterization (11.4 days) was higher than the study of Berhanu Nega (4.7 +/- 0.7 days). Wound infection occurred in 14(8.75%) which is higher than reported in Iran by Zargooshi (1.2%) but smaller than reported in Sudan (23.4%)[ 8 ] and they were treated with wound care, antibiotics and later closure of the wound. Vesico-cutaneous fistulae occurred in 4 (2.5%) smaller than reports from Sudan(14.4%)[ 8 ] and managed with prolonged transurethral catheterization. Epididymo-orchitis in 5 patients, UTI in 8 patient and pneumonia in 2 cases occurred and all were managed successfully with antibiotics. The overall incontinence rate in the early post op period on this paper showed 26.7%, higher than reported in Germany’s paper (13.5%)[ 9 ]. The overall persistent incontinence rate at 6th month and 1year were 7.5% and 4.4% which is comparable to Indian study(8%)[ 2 ] and higher than reported by Ceylon (0.9%)[ 10 ] and Italian paper(1.7%)[ 13 ] Stress and Urge incontinence was seen in 6.3% and 17.5% in the early post-operative period but reduced to 2.5% and 5% on 6th month follow up visit whereas similar study in Germany by C. Adam [ 9 ] showed 5.97% and 7.5% of cases, all subsided beyond 10 week post op. Total incontinence occurred in 5(3.1%) of patient at 1 month visit but all subsided on their 6th month and 1year follow up visit, Italian paper showed 1.7% have 6 month persisted incontinence rate with the mean nationwide prevalence of 1%(range 0.1-3%) In our study 4 (2.5%) patient developed urethral stricture on their 6th month follow up which is comparable to Ceylon’s report(2.2%)[ 10 ] and slightly lower than Indian report (4%)[ 2 ] Conclusions. In this review trans vesical prostatectomy found to be successful with good long-term outcome and a low complication rate. Its success has a long lasting effect and only rarely was a surgical procedure necessary to correct its adverse effect. This approach should be included in the list of possible treatments to discuss with the patient having a large prostate and in a set up where endoscopic instrument not available. Recommendation - We recommend prospective study with large sample size and a longer duration of follow up to assess long term complications like recurrence of symptoms Limitation - Incomplete data recording like pre and post op sexual status, short duration of patient follow up after surgery and significant number of patient follow up charts was lost/not found from the store and incomplete documentation on digital recording system was among the main challenge of this study. Declarations Competing interests The authors decleare no competing interests. Clinical trial number Not applicable Ethics Statement Human Ethics and Consent to Participate declarations: not applicable Funding declerations This research received no specific grant from any funding agency, commercial, or not-for-profit sectors. Author Contribution Dr Fasil Wondmu Wale and Dr Wondewosen Lemma Lette conceptualized the study and designed the methodology. F.W.W. collected and analyzed the data, while W.L.L. contributed to data interpretation. F.W.W. wrote the initial draft of the manuscript, and W.L.L. provided critical revisions. Both authors contributed to the final editing and approved the manuscript for submission. Data Availability The datasets used and/or analyzed during the current study were obtained from patient medical records and are not publicly available due to confidentiality and ethical restrictions. The data relevant to the manuscript is included within the article itself. However, de-identified data may be available from the corresponding author upon reasonable request and with approval from the Institutional Health Ethics Review Committee (IHRERC) of Addis Ababa University. References P. E. Briant and A. Ruffion, “Surgical treatment of benign prostatic hyperplasia,” Prog. en Urol. , vol. 19, no. 4, pp. 274–278, 2009, doi: 10.1016/j.purol.2008.10.031. S. Gupta and H. H. Maharaul, “International Journal of Biomedical Research A Comparative Study of Post Operative Complications of Open Prostatectomy (Fryer’s) Versus Trans Urethral Resection of Prostate,” Int. J. Biomed. Res. , vol. 6, no. 09, p. 6, 2015, doi: 10.7439/ijbr. O. R. et al. , “Transurethral enucleation and resection of the prostate vs transvesical prostatectomy for prostate volumes >80 mL: A prospective randomized study,” BJU Int. , 2013. J. Varkarakis, G. Bartsch, and W. Horninger, “Long-Term Morbidity and Mortality of Transurethral Prostatectomy: A 10-Year Follow-Up,” Prostate , vol. 58, no. 3, pp. 248–251, 2004, doi: 10.1002/pros.10339. A. A. Salako, T. A. Badmus, A. M. Owojuyigbe, R. A. David, C. U. Ndegbu, and C. I. Onyeze, “Open Prostatectomy in the Management of Benign Prostate Hyperplasia in a Developing Economy,” Open J. Urol. , vol. 06, no. 12, pp. 179–189, 2016, doi: 10.4236/oju.2016.612029. E. Suer, I. Gokce, O. Yaman, K. Anafarta, and O. Göǧüş, “Open Prostatectomy Is Still a Valid Option for Large Prostates: A High-Volume, Single-Center Experience,” Urology , vol. 72, no. 1, pp. 90–94, 2008, doi: 10.1016/j.urology.2008.03.015. P. T. Adegun, J. O. Esho, and P. B. Adebayo, “Medical Science Open Prostatectomy in a Nascent Teaching Hospital in Nigeria: A 5-Year Survey,” IJSR -INTERNATIONAL J. Sci. Res. , 2015. A. Latif Khalifa Elnaim, M. Ibnouf, M. Magzoub, A. K. Latif Elnaim, M. M. M Ibnouf, and F. M. Toum, “Post Transvesical Prostatectomy (TVP) Complications, Risk Assessment Using Clavien-Dindo System in Kassala Teaching Hospital,” Glob. j. Surg. , vol. 5, no. 1, pp. 1–5, 2017, doi: 10.12691/js-5-1-1. Alfons Hofstetter Christoph Adam, “Retropubic Transvesical Prostatectomy for Significant Prostatic Enlargement Must Remain a Standard Part of Urology Training.” K. Ceylan, Y. Y. Üniversitesi, T. Fakültesi, and Ü. A. D. Van -Türkiye, “OPEN PROSTATECTOMY THE RESULTS OF A SERIES OF 320 CASES IN RURAL AREA,” 2006. B. Nega, “The safety and efficacy of trans-vesical prostatectomy done at a primary general hospital setting in Ethiopia,” East Cent. African J. Surg. , vol. 13, no. 2, pp. 53–60, 2008. J. Zargooshi, “Open prostatectomy for benign prostate hyperplasia: Short-term outcome in 3000 consecutive patients,” Prostate Cancer and Prostatic Diseases , vol. 10, no. 4. pp. 374–377, 2007, doi: 10.1038/sj.pcan.4500986. E. Mearini, M. Marzi, L. Mearini, A. Zucchi, and M. Porena, “Open Prostatectomy in Benign Prostatic Hyperplasia: 10-Year Experience in Italy,” 1998. [Online]. Available: http://biomednet.com/karger. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5940883","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":433486899,"identity":"f35ea528-1439-4494-9824-0c63f96c32b7","order_by":0,"name":"Wondewosen Lette","email":"","orcid":"","institution":"Haramaya University","correspondingAuthor":false,"prefix":"","firstName":"Wondewosen","middleName":"","lastName":"Lette","suffix":""},{"id":433486900,"identity":"2af71406-6366-4990-9a54-17be50f25e9b","order_by":1,"name":"Fasil Wale","email":"data:image/png;base64,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","orcid":"","institution":"Haramaya University","correspondingAuthor":true,"prefix":"","firstName":"Fasil","middleName":"","lastName":"Wale","suffix":""}],"badges":[],"createdAt":"2025-02-01 09:08:22","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5940883/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5940883/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":79256939,"identity":"6873b099-30e5-4b1f-a41a-e5646200feb6","added_by":"auto","created_at":"2025-03-26 09:02:37","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":23398,"visible":true,"origin":"","legend":"\u003cp\u003eAge distribution of patient (n=160)\u003c/p\u003e","description":"","filename":"1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-5940883/v1/fb1ceaa3f8d0e1b8702746d0.jpg"},{"id":79256942,"identity":"8e962d96-64fe-41d4-b651-d8621fa3d9bf","added_by":"auto","created_at":"2025-03-26 09:02:37","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":31196,"visible":true,"origin":"","legend":"\u003cp\u003ePatient comorbidity\u003c/p\u003e","description":"","filename":"2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-5940883/v1/330f30209b4fac6f27426f5f.jpg"},{"id":79256940,"identity":"afa16387-b4e4-490c-b914-b0ccc58011bf","added_by":"auto","created_at":"2025-03-26 09:02:37","extension":"jpg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":45090,"visible":true,"origin":"","legend":"\u003cp\u003eEarly and late postoperative problems\u003c/p\u003e","description":"","filename":"3.jpg","url":"https://assets-eu.researchsquare.com/files/rs-5940883/v1/8bce2911b84220cf19ae1f97.jpg"},{"id":97771036,"identity":"6f2660fa-d953-4d4d-8f34-87b2728d278d","added_by":"auto","created_at":"2025-12-09 08:08:22","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":644813,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5940883/v1/64398ae1-24bf-4ac2-95c8-aa93dd42b185.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eLong Term Outcomes of Trans Vesical Prostatectomy for Benign Prostatic Hyperplasia\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eBenign Prostatic hyperplasia (BPH) is the commonest cause of urinary problems in elderly males affecting the quality of life[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Urinary retention due to prostatic disease is a major geriatric problem[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Modalities of treatment include watchful waiting, medical treatment like alpha blockers and 5-@ reductase inhibitor for mild to moderate symptoms and surgical treatment like TUIP, TURP, open prostatectomy, etc.[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eTrans vesical prostatectomy (TVP) is a popular type of open prostatectomy; however, the application of TVP for large prostates has been progressively decreasing over the years with the advent of minimally invasive techniques, including monopolar and bipolar TURP, photoselective vaporization techniques, different laser therapies, etc.[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Currently, TURP is considered as the reference or standard treatment for the prostate less than 70 to 80 g[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. However open prostatectomy is still being performed for operations of the prostates that are candidate for TURP in many developing countries especially in Africa partly due to poor availability of endoscopic equipment \u0026amp; scarcity of trained endoscopic personnel[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe aim of this study was to provide information about the long-term efficacy of trans vesical prostatectomy from a contemporary series of patients.\u003c/p\u003e "},{"header":"Methods and Materials","content":"\u003cp\u003eFrom January 2019 to December 2020, 212 patients underwent open trans vesical prostatectomy in the three hospitals. The indications for surgical management were urinary retention and other complications and/or bothersome lower urinary tract symptoms (LUTS) attributed to BPH. Fifty patients with lost follow up chart and incomplete follow up data were excluded from the study. Another two patient with post operative biopsy result indicating prostatic cancer and pre operative cystoscopy showing urethral stricture were excluded from the study. The final study group included 160 patients who underwent open trans vesical prostatectomy. All the data were analyzed by the same investigator to ensure strict inclusion criteria. Consent for the study was obtained from the hospital ethical committee and submitted to the respective hospital administrator. Data collection tools were prepared as semi structured check list and categorized as sociodemographic, pre operative, intra operative and post operative data. Intra operative complications were defined as complications occurring at the time of surgery; early when within the first 30 days after surgery; and late when beyond 30 days after surgery.\u003c/p\u003e\n\u003ch2\u003eEthical considerations\u003c/h2\u003e\n\u003ch3\u003eEthics Approval Statement:\u003c/h3\u003e\n\u003cp\u003eEthical clearance for the study was obtained from the Institutional Health Ethics Review Committee of the College of Health and Medical Sciences, Addis Ababa University, in accordance with national ethical guidelines and the university's commitment to research ethics. The research was conducted in compliance with the Helsinki Declaration and in accordance with the relevant guidelines. Prior to data collection, an official letter was obtained from the College and submitted to the responsible authorities to ensure compliance with institutional protocols.\u003c/p\u003e\n\u003ch3\u003eConsent to Participate Statement:\u003c/h3\u003e\n\u003cp\u003eInformed consent was obtained from all study participants before their inclusion in the study. To ensure confidentiality, no patient names were recorded in the data collection format. Additionally, patient cards were returned to the card room immediately after data collection was completed, adhering to ethical norms for data security and patient privacy.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eSocio-demographic and pre-operative results\u003c/p\u003e \u003cp\u003eThe mean age of the patient was 67.39years (range from 45 to 96years) with SD 9.298. Majority of the patients were from Addis Ababa (80%) followed by Oromia region (12.5%), Amhara (4.4%) and Southern Nation (3.1%).\u003c/p\u003e \u003cp\u003eAround 54 (33.75%) patients had minimum of one comorbidity, HTN found in 34(21.3%), DM in 5(3.1%), coexistence of hypertension and DM in 8(5%), cardiac and asthma in 3 patients each; and RVI in one.\u003c/p\u003e \u003cp\u003ePreoperative U/A or urine culture was done for 115 patients and of these 43(37.4%) of them has result suggestive of UTI and they were treated before or following the surgery. Cystoscopy was done for 61(38.1%) patients for an indication of hematuria history, to assess the size of prostate and to rule out urethral stricture.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePre operative U/A or urine culture\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercent\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eValid Percent\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eCumulative Percent\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003eValid\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eU/A not done\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e28.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e28.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e28.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eU/A shows None Revealing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e43.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e43.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e71.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eU/A shows UTI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e24.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e24.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e95.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrine Culture shows no growth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e97.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrine culture shows growth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e100.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e160\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e100.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e100.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e, Patients\u0026rsquo; peri-operative data \u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMinimum\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMaximum\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eStd. Deviation\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDuration of catheterization in weeks\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e6.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e6.344\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProstate volume (in CC) by Abdominopelvic Ultrasound\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e158\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e287\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e96.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e46.602\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSize of transurethral catheter\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e152\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e21.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.764\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTrans urethral catheter balloon inflated in cc\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e150\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e80.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e35.0333\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e9.89028\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDuration of post op catheterization\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e159\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e11.40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e7.839\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDuration of hospital stay before surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e160\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e3.470\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDuration of hospital stay after surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e160\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e4.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e3.071\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eValid N (listwise)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e\u003cp\u003eAll patients presented with LUTS of 2 months to \u0026gt;\u0026thinsp;10 years duration, majority being in 1-2years 62(38.8%) followed by 2\u0026ndash;5 years 49(30.6%) and \u0026lt;\u0026thinsp;6months 20(12.5%). One hundred thirty-three patients (83.1%) presented with complaints of severe urinary symptoms the rest with moderate 11(6.9%) and moderate to severe 16(10%) LUTS. Ninety-six (60%) of them had been catheterized preoperatively due to urinary retention, AUR 86(53.8%) \u0026amp; CUR 10(6.3%) for a mean duration of catheterization of 6.75weeks (range of 1\u0026ndash;50 weeks). The most common indication of TVP was recurrent AUR 84(52.5%) followed by bothersome LUTS 52(32.5%), failed medical therapy 10(6.3%), CUR 9(5.6%), hematuria (4) and recurrent UTI (1). The average size of prostate by preoperative trans abdominal ultrasound estimation was found to be 96.54 ranging from 29cc- 287cc, SD\u0026thinsp;=\u0026thinsp;46.6.\u003c/p\u003e \u003cp\u003ePerioperative data results\u003c/p\u003e \u003cp\u003eOne hundred thirty-five (84.4%) of patient were operated under spinal anesthesia (SA) followed by SA\u0026thinsp;+\u0026thinsp;sedation 10(6.3), General Anesthesia 9(5.6%) and failed SA\u0026thinsp;+\u0026thinsp;GA 6 (3.8%). The majority of the procedure was done by year 1 urology residents 79(49.4%) followed by 2nd year urology resident 50(31.3%) and final year general surgery resident 20 (12.5%) under consultant supervision. Majority of the surgery took 60\u0026ndash;90 minutes (53.8%) followed by \u0026gt;\u0026thinsp;90 minutes in 67 (41.8%) cases and \u0026lt;\u0026thinsp;60 minute in 7 (4.4%) patients. Intra op accident were noticed in 5 (3.1%) patients and it include prostatic capsular breach in 2 (1.2%), bowel injury in 1 and intra op hypotension and hypertension each of them 1 case. Perioperative transfusion for significant bleeding was required in 12(7.5%) patients.\u003c/p\u003e \n\u003cp\u003eTable 3. Anesthetic consideration and surgeon detail\u003c/p\u003e\n\u003cp\u003e\u003cimg 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\" width=\"506\" height=\"449\"\u003e\u003c/p\u003e\u003cp\u003eThe mean duration of hospital stay before surgery was 3.09 days (range 1\u0026ndash;30 days) and after surgery 4.84 days (range 2\u0026ndash;27 days). The mean duration of catheterization after surgery was 11.4days (ranged from 6-69days). Trial of voiding on catheter removal was failed in only 3(1.9%) patients and rest successfully voided.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCorrelation between SSI, Preoperative Catheterization and Duration of Hospital Stay\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDuration of post operative catheterization\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eDuration of hospital stay after surgery\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eWound site infection\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003ePre operative catheterization\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eDuration of post operative catheterization\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePearson Correlation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.340\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.507\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.079\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSig. (2-tailed)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.323\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e159\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e159\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e159\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e159\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eDuration of hospital stay after surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePearson Correlation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.340\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.473\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.158\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSig. (2-tailed)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.045\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e159\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e160\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e160\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e160\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eWound site infection\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePearson Correlation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.507\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.473\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.123\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSig. (2-tailed)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.122\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e159\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e160\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e160\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e160\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003ePre operative catheterization\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePearson Correlation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.079\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.158\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.123\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSig. (2-tailed)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.323\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.045\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.122\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e159\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e160\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e160\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e160\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e**. Correlation is significant at the 0.01 level (2-tailed).\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e*. Correlation is significant at the 0.05 level (2-tailed).\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThere was significant association between preoperative catheterization and duration of hospital stay after the surgery (p- value\u0026thinsp;=\u0026thinsp;\u0026lt;\u0026thinsp;0.05) and also there was significant correlation between duration of hospital stay after surgery with duration of post operative catheterization and wound site infection (p-value\u0026thinsp;=\u0026thinsp;\u0026lt;\u0026thinsp;0.01).\u003c/p\u003e \u003cp\u003eResults in the Early and late post-operative period\u003c/p\u003e \u003cp\u003eAbout 143(89.3%)) have reported improvement in post operative LUTS at their 1st visit, 148(92.5%) at 1 month visit and 157 (98.1%) at 6th month follow up. Complication occurring in the early postoperative period were: Surgical Site Infection (SSI) 14 (8.75%), 13 of them were superficial, and vesico-cutaneous fistulae in 4 (2.5%), epididymo-orchitis in 5 patients, UTI in 8 patient and pneumonia in 2 of cases. Reoperation during the same admission was reported in 3 cases, 2 of them for bleeding and 1 patient for iatrogenic bowel injury.\u003c/p\u003e \u003cp\u003eAbout 46(28.75%) patients reported some form of incontinence on their first visit and of these 3 of them reported total improvement of incontinence on their 1st month follow up. Only 12 patient reported persistence of incontinence at their 6month follow up with urge incontinence in 8 patient and stress incontinence in 4 patients. No patient with total incontinence at 6 months follow up period reported. A total of five (3.1%) patient developed urethral stricture, four on their 6th month and 1 additional patient at 1year follow up visit; and subsequently all were treated with optical urethrotomy and serial dilatation under cystoscopy guidance and bouginage. Three patient reported ED postoperatively but preoperative and post-operative sexual status was not documented for the rest of the patient. Additional outcome measures including International Prostate Symptom Score, maximal uroflowmetry rates, and postvoid residual urine were not used consistently in our cases. There was no mortality intraoperatively or in the early postoperative period.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eIn our study the mean age of the patients was 67.4 (graph-1),similar to the study in Turkey 67.5 years (n\u0026thinsp;=\u0026thinsp;664)[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e] ;comparable to a mean age of 65.36 years and in a range of 69.4\u0026thinsp;\u0026plusmn;\u0026thinsp;8.5 SD years in studies done in Nigeria (n\u0026thinsp;=\u0026thinsp;362) [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]and Sudan(n\u0026thinsp;=\u0026thinsp;188)[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e] respectively, but lower than the study done in Germany with a mean age of 70 years (n\u0026thinsp;=\u0026thinsp;201)[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Around 33.75% of patients had comorbidity, hypertension being the most frequent (21.3%) followed by coexisting DM \u0026amp; hypertension (5%); and DM (3.1%) patients (graph-2). Whereas similar study done in Turkey showed comorbidity rate of 72% ( n\u0026thinsp;=\u0026thinsp;320)[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e] .\u003c/p\u003e \u003cp\u003eThe most common indication in our study is recurrent AUR (52.5%), smaller than reported by Berhanu Nega(81.3%)(n\u0026thinsp;=\u0026thinsp;64) in Ethiopia[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e] and other similar study in Iran (60.8%)[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e] ;and 66.68% by Adegun in Nigeria[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. The mean duration of catheterization was 6.75weeks, similar to Berhanu Nega\u0026rsquo;s study (6.5 weeks).\u003c/p\u003e \u003cp\u003ePerioperative transfusion rate in our study was 7.5%,which is lower than report in Turkey(12.7%)[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e] but higher than stated by Zargooshi (3.3%) [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e] and Reoperation in the same admission was needed in 3(1.9%) comparable to Zargooshi( 1%). The mean duration of hospital stay was 7.93 days (3.09 days before and 4.84 days after surgery) in the range reported by Berhanu Nega (6.94 +/- 1.7 days) but the average duration of post OP catheterization (11.4 days) was higher than the study of Berhanu Nega (4.7 +/- 0.7 days).\u003c/p\u003e \u003cp\u003eWound infection occurred in 14(8.75%) which is higher than reported in Iran by Zargooshi (1.2%) but smaller than reported in Sudan (23.4%)[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e] and they were treated with wound care, antibiotics and later closure of the wound. Vesico-cutaneous fistulae occurred in 4 (2.5%) smaller than reports from Sudan(14.4%)[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e] and managed with prolonged transurethral catheterization. Epididymo-orchitis in 5 patients, UTI in 8 patient and pneumonia in 2 cases occurred and all were managed successfully with antibiotics. The overall incontinence rate in the early post op period on this paper showed 26.7%, higher than reported in Germany\u0026rsquo;s paper (13.5%)[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. The overall persistent incontinence rate at 6th month and 1year were 7.5% and 4.4% which is comparable to Indian study(8%)[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e] and higher than reported by Ceylon (0.9%)[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e] and Italian paper(1.7%)[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eStress and Urge incontinence was seen in 6.3% and 17.5% in the early post-operative period but reduced to 2.5% and 5% on 6th month follow up visit whereas similar study in Germany by C. Adam [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e] showed 5.97% and 7.5% of cases, all subsided beyond 10 week post op. Total incontinence occurred in 5(3.1%) of patient at 1 month visit but all subsided on their 6th month and 1year follow up visit, Italian paper showed 1.7% have 6 month persisted incontinence rate with the mean nationwide prevalence of 1%(range 0.1-3%)\u003c/p\u003e \u003cp\u003eIn our study 4 (2.5%) patient developed urethral stricture on their 6th month follow up which is comparable to Ceylon\u0026rsquo;s report(2.2%)[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e] and slightly lower than Indian report (4%)[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eConclusions. In this review trans vesical prostatectomy found to be successful with good long-term outcome and a low complication rate. Its success has a long lasting effect and only rarely was a surgical procedure necessary to correct its adverse effect. This approach should be included in the list of possible treatments to discuss with the patient having a large prostate and in a set up where endoscopic instrument not available.\u003c/p\u003e \u003cp\u003eRecommendation - We recommend prospective study with large sample size and a longer duration of follow up to assess long term complications like recurrence of symptoms\u003c/p\u003e \u003cp\u003eLimitation\u003cb\u003e-\u003c/b\u003e Incomplete data recording like pre and post op sexual status, short duration of patient follow up after surgery and significant number of patient follow up charts was lost/not found from the store and incomplete documentation on digital recording system was among the main challenge of this study.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e \u003cstrong\u003eCompeting interests\u003c/strong\u003e \u003cp\u003eThe authors decleare no competing interests.\u003c/p\u003e \u003c/p\u003e\u003cp\u003e \u003ch2\u003eClinical trial number\u003c/h2\u003e \u003cp\u003eNot applicable\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eEthics Statement\u003c/strong\u003e \u003cp\u003eHuman Ethics and Consent to Participate declarations: not applicable\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e \u003cp\u003edeclerations\u003c/p\u003e \u003cp\u003eThis research received no specific grant from any funding agency, commercial, or not-for-profit sectors.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eDr Fasil Wondmu Wale and Dr Wondewosen Lemma Lette conceptualized the study and designed the methodology. F.W.W. collected and analyzed the data, while W.L.L. contributed to data interpretation. F.W.W. wrote the initial draft of the manuscript, and W.L.L. provided critical revisions. Both authors contributed to the final editing and approved the manuscript for submission.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eThe datasets used and/or analyzed during the current study were obtained from patient medical records and are not publicly available due to confidentiality and ethical restrictions. The data relevant to the manuscript is included within the article itself. However, de-identified data may be available from the corresponding author upon reasonable request and with approval from the Institutional Health Ethics Review Committee (IHRERC) of Addis Ababa University.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eP. E. Briant and A. Ruffion, \u0026ldquo;Surgical treatment of benign prostatic hyperplasia,\u0026rdquo; \u003cem\u003eProg. en Urol.\u003c/em\u003e, vol. 19, no. 4, pp. 274\u0026ndash;278, 2009, doi: 10.1016/j.purol.2008.10.031.\u003c/li\u003e\n\u003cli\u003eS. Gupta and H. H. Maharaul, \u0026ldquo;International Journal of Biomedical Research A Comparative Study of Post Operative Complications of Open Prostatectomy (Fryer\u0026rsquo;s) Versus Trans Urethral Resection of Prostate,\u0026rdquo; \u003cem\u003eInt. J. Biomed. Res.\u003c/em\u003e, vol. 6, no. 09, p. 6, 2015, doi: 10.7439/ijbr.\u003c/li\u003e\n\u003cli\u003eO. R. \u003cem\u003eet al.\u003c/em\u003e, \u0026ldquo;Transurethral enucleation and resection of the prostate vs transvesical prostatectomy for prostate volumes \u0026gt;80 mL: A prospective randomized study,\u0026rdquo; \u003cem\u003eBJU Int.\u003c/em\u003e, 2013.\u003c/li\u003e\n\u003cli\u003eJ. Varkarakis, G. Bartsch, and W. Horninger, \u0026ldquo;Long-Term Morbidity and Mortality of Transurethral Prostatectomy: A 10-Year Follow-Up,\u0026rdquo; \u003cem\u003eProstate\u003c/em\u003e, vol. 58, no. 3, pp. 248\u0026ndash;251, 2004, doi: 10.1002/pros.10339.\u003c/li\u003e\n\u003cli\u003eA. A. Salako, T. A. Badmus, A. M. Owojuyigbe, R. A. David, C. U. Ndegbu, and C. I. Onyeze, \u0026ldquo;Open Prostatectomy in the Management of Benign Prostate Hyperplasia in a Developing Economy,\u0026rdquo; \u003cem\u003eOpen J. Urol.\u003c/em\u003e, vol. 06, no. 12, pp. 179\u0026ndash;189, 2016, doi: 10.4236/oju.2016.612029.\u003c/li\u003e\n\u003cli\u003eE. Suer, I. Gokce, O. Yaman, K. Anafarta, and O. G\u0026ouml;ǧ\u0026uuml;ş, \u0026ldquo;Open Prostatectomy Is Still a Valid Option for Large Prostates: A High-Volume, Single-Center Experience,\u0026rdquo; \u003cem\u003eUrology\u003c/em\u003e, vol. 72, no. 1, pp. 90\u0026ndash;94, 2008, doi: 10.1016/j.urology.2008.03.015.\u003c/li\u003e\n\u003cli\u003eP. T. Adegun, J. O. Esho, and P. B. Adebayo, \u0026ldquo;Medical Science Open Prostatectomy in a Nascent Teaching Hospital in Nigeria: A 5-Year Survey,\u0026rdquo; \u003cem\u003eIJSR -INTERNATIONAL J. Sci. Res.\u003c/em\u003e, 2015.\u003c/li\u003e\n\u003cli\u003eA. Latif Khalifa Elnaim, M. Ibnouf, M. Magzoub, A. K. Latif Elnaim, M. M. M Ibnouf, and F. M. Toum, \u0026ldquo;Post Transvesical Prostatectomy (TVP) Complications, Risk Assessment Using Clavien-Dindo System in Kassala Teaching Hospital,\u0026rdquo; \u003cem\u003eGlob. j. Surg.\u003c/em\u003e, vol. 5, no. 1, pp. 1\u0026ndash;5, 2017, doi: 10.12691/js-5-1-1.\u003c/li\u003e\n\u003cli\u003eAlfons Hofstetter Christoph Adam, \u0026ldquo;Retropubic Transvesical Prostatectomy for Significant Prostatic Enlargement Must Remain a Standard Part of Urology Training.\u0026rdquo;\u003c/li\u003e\n\u003cli\u003eK. Ceylan, Y. Y. \u0026Uuml;niversitesi, T. Fak\u0026uuml;ltesi, and \u0026Uuml;. A. D. Van -T\u0026uuml;rkiye, \u0026ldquo;OPEN PROSTATECTOMY THE RESULTS OF A SERIES OF 320 CASES IN RURAL AREA,\u0026rdquo; 2006.\u003c/li\u003e\n\u003cli\u003eB. Nega, \u0026ldquo;The safety and efficacy of trans-vesical prostatectomy done at a primary general hospital setting in Ethiopia,\u0026rdquo; \u003cem\u003eEast Cent. African J. Surg.\u003c/em\u003e, vol. 13, no. 2, pp. 53\u0026ndash;60, 2008.\u003c/li\u003e\n\u003cli\u003eJ. Zargooshi, \u0026ldquo;Open prostatectomy for benign prostate hyperplasia: Short-term outcome in 3000 consecutive patients,\u0026rdquo; \u003cem\u003eProstate Cancer and Prostatic Diseases\u003c/em\u003e, vol. 10, no. 4. pp. 374\u0026ndash;377, 2007, doi: 10.1038/sj.pcan.4500986.\u003c/li\u003e\n\u003cli\u003eE. Mearini, M. Marzi, L. Mearini, A. Zucchi, and M. Porena, \u0026ldquo;Open Prostatectomy in Benign Prostatic Hyperplasia: 10-Year Experience in Italy,\u0026rdquo; 1998. [Online]. Available: http://biomednet.com/karger.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Trans Vesical Prostatectomy, Benign Prostatic Hyperplasia (BPH), Open Prostatectomy, Lower Urinary Tract Symptoms (LUTS), Long-term Outcomes, Symptom Improvement, Postoperative Complications, Retrospective Study, Urethral Stricture, Urinary Incontinence, Surgical Outcomes, Developing Countries, Ethiopia","lastPublishedDoi":"10.21203/rs.3.rs-5940883/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5940883/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eBackground. 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.\u003c/p\u003e\n\u003cp\u003eMethods. 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.\u003c/p\u003e\n\u003cp\u003eResults. 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%).\u003c/p\u003e\n\u003cp\u003eConclusions. 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.\u003c/p\u003e","manuscriptTitle":"Long Term Outcomes of Trans Vesical Prostatectomy for Benign Prostatic Hyperplasia","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-03-26 09:02:32","doi":"10.21203/rs.3.rs-5940883/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"32b669f4-de64-40a2-9dbb-ca1c91810c36","owner":[],"postedDate":"March 26th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-12-09T08:08:11+00:00","versionOfRecord":[],"versionCreatedAt":"2025-03-26 09:02:32","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5940883","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5940883","identity":"rs-5940883","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}