Early clinical outcome of modified retropubic versus transvesical prostatectomy in management of benign prostatic hyperplasia: A randomized clinical trial.
Masaba, Joseph benon
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TITTLE: Early clinical outcome of modified retropubic prostatectomy versus transvesical prostatectomy in management of BPH: Arandomized clinical trial. OBJECTIVES: To determine the early clinical outcome of modified retropubic prostatectomy versus transversical prostatectomy in surgical management of BPH. STUDY DESIGN: A single blind randomzed clinical trial PATIENTS AND METHODS: The study comprised of a prospective and randomized analysis of 37 men with BPH who underwent open prostatectomy between September 2007 and April 2008. Two techniques were used; In group 1, patients had the modified retropubic prostatectomy, and in group 2, patients had the transvesical prostatectomy. Change in haemoglobin and haematocrit levels on third day following surgery, duration of urinary bladder irrigation, and wound sepsis at site of incision were analyzed. RESULTS: Mean reduction in haemoglobin level in the modified retropubic and tranvesical arms was 1.4g/dl (p<0.0001), and 3.34g/dl(p<0.0001) respectively. Mean reduction in haematocrit level was 4.49% and 10.77% respectively. Three (16%) patients in the tranvesical arm received a blood transfusion following prostatectomy. Two (11%) patients in the modified retropubic arm and three (16%) of patients in the transvesical arm developed clot retension after prostatectomy, Fifteen (83%) patients in the modified retropubic arm stayed for less than 5 postoperative days in hospital, Twelve (63%) patients in transvesical arm, stayed for longer than 5 days, following surgery. One (2.7%) patient in the transvesical arm developed extravasation of urine. There was no deaths reported in either treatment arm. CONCLUSION: Modified retropubic prostatectomy significantly reduces the amount of blood loss among patients undergoing prostatectomy compared to transvesical prostatectomy; (p value<0.0001), rendering it a safe option for surgically treating patients with BPH in Mulago hospital. It is also associated with a significantly shorter post-operative hospital stay as compared to transvesical prostatectomy; (p value=0.0004).