The Role of Transurethral Resection of the Prostate (TURP) in the Surgical Management of Benign Prostatic Hyperplasia in the Urology Department of the Libreville University Hospital

Abstract

Introduction: Prostate surgery accounts for a significant proportion of urological surgical procedures. With the advent of endoscopy, conventional surgery has gradually given way to these new techniques. In this study, we evaluate the role of TURP in the management of benign or malignant prostate enlargement in the urology department of the Libreville University Hospital. Patients and Methods: This was a retrospective, descriptive, single-center study conducted in the urology department of the Libreville University Hospital Center (CHUL) over the period from January 1, 2022, to December 31, 2024. Patients who underwent surgery for benign or malignant prostatic hypertrophy and had complete medical records were included. The parameters studied were age, reason for consultation, surgical indication, ultrasound prostate volume, approach, operating time, postoperative outcomes with the occurrence of any complications, quality of urination, and duration of postoperative urinary catheterization. Data analysis was performed by calculating means and frequencies. Results: During the study period, a total of 131 patients underwent surgery for prostatic hypertrophy, including 99 who underwent transvesical prostatectomy (75.57%) and 32 patients (24.43%) who underwent transurethral resection of the prostate. The average age of our patients was 65.1 years (range: 45 to 90 years). The average operating time for transvesical adenomectomy was 90 minutes, while it was 65 minutes for resection. The urinary catheter was kept in place for an average of 9 days in the case of adenomectomy and 2 days in the case of resection. The average prostate volume was 98.47 g for conventional surgery and 37.25 g for endoscopy. Conclusion: Despite the many advantages of endoscopy compared to conventional surgery, the practice of TURP at the Libreville University Hospital, although effective, accounts for only a quarter of prostate surgery. A steady supply of endoscopic equipment would enable the continuation and widespread use of this prostate approach. Furthermore, equipping our facilities with lasers would enable us to perform high-volume prostate surgery by vaporization or enucleation, which would ultimately allow endoscopy to surpass open surgery, as is the case in the West and North Africa.