Results of an Eight Year Long Practice of Saline Bipolar Transurethral Resection of Prostate

Abstract

Background: Open prostatectomy has long been the only prostatic bladder outlet obstruction&#8217;s surgery available in Benin. It is prone to postoperative bleeding and infections and is not suitable for prostate cancer-induced bladder outlet obstruction. Objective: To evaluate the first results of endoscopic surgery of prostatic bladder outlet obstruction in our environment. Patients and Method: We conducted an observational study of saline bipolar transurethral resection of prostate (B-TURP) at the former Military Teaching Hospital of Cotonou. We retrospectively collected the data from patients&#8217; medical records from November 17, 2014, to September 7, 2022. We used Excel 2019 to make a descriptive analysis of the data. Results: Saline B-TURP was performed in 60 consecutive patients. Their mean age was 69.1 years (range: 48-85). The procedure was indicated in 22 (36.7%), 32 (53.3%), 3 (5%), and 3 (5%) patients, respectively for acute urinary retention, chronic urinary retention, obstructive renal failure, and unresponsiveness to alpha-blockers. 35 patients (58.3%) had prostate cancer (PCa). 25 patients (41.7) had benign prostate hyperplasia (BPH). No patient got a blood transfusion. The duration of postoperative hospitalization was 3 days (88.3%) to 5 days (11.7%). 5 patients (8.3%), <i>i.e.</i>, 3 BPH and 2 prostate cancer patients got preoperative urinary tract infection. The causative bacteria were <i>Escherichia coli</i> in 3 patients (60%), <i>Klebsiella pneumoniae</i> in 2 patients (40%), and multi-resistant Acinetobacter as a metachronous infection to <i>Escherichia coli</i> in 1 patient (20%). All the infections were associated with indwelling Foley catheter. 7 patients (11.7%), <i>i.e.</i>, 3 BPH and 4 prostate cancer patients, got a second resection to recover full spontaneous micturition. Prostate size was available in the medical record of 21 BPH patients and 15 prostate cancer patients. Prostate size ranged from 22 to 123 g with a mean value of 61.1 g in BPH patients, and from 34 to 180 g with a mean value of 82.8 g in prostate cancer patients. The overall mean prostate size was 70.1 g. Conclusion: Saline B-TURP was a safe surgery for bladder outlet obstruction in either benign prostate hyperplasia or prostate cancer patients.