DOI: http://dx.doi.org/10.18203/2349-2902.isj20204432

Monopolar trans-urethral resection of prostate: our initial experience in a new African hospital with few resources

Usman Mohammed Tela, Abdu Mohammed Lawan, Babatunde David Olajide

Abstract


Background: Diseases of the prostate including benign prostate hyperplasia constitute a significant portion of cases that are routinely managed by urologists worldwide. Where there is need for surgical intervention of clinical BPH, monopolar trans-urethral resection of prostate is a gold standard surgical option. The objective of our study is to describe and share our initial experience of monopolar TURP in our new African hospital with few resources, a stepping stone for future comprehensive research on TURP and urology capacity building.

Methods: Retrospective study of twelve patients who had M-TURP using sterile distilled water as irrigation fluid over one year period, at Yobe State University teaching hospital, a new hospital in North-Eastern Nigeria. Data related to the TURP were extracted from the patients’ folders and operation theatre register, and then analyzed.

Results: The mean age of patients was 67.4 years, recurrent urine retention was the commonest indication for M-TURP (50.0%), preoperative mean volume of prostate was 45.8 ml , mean duration of surgery was 63.8 minutes and mean weight resected prostatic chips was 18.4 grams. There was low complication rate (16.7%).

Conclusions: M-TURP using sterile water as irrigation fluid is efficacious, reliable and pocket-friendly surgical option for our patients that needed surgery for clinical BPH. Patient selection and minimizing the time spent on M-TURP are of paramount importance in avoiding or reducing the risk of complications as observed in our study.

 


Keywords


Monopolar trans-urethral resection of prostate, Sterile water, BPH, TURP

Full Text:

PDF

References


Nwafor CC, Keshinro OS, Abudu EK. A histopathological study of prostate lesions in Lagos, Nigeria: A private practice experience. Niger Med J. 2015;56(5):338-43.

Lim KB. Epidemiology of clinical benign prostatic hyperplasia. Asian J Urol. 2017;4(3):148-51.

McConnell JD, Barry MJ, Bruskewitz RC. Benign prostatic hyperplasia: diagnosis and treatment. Agency for Health Care Policy and Research. Clin Pract Guidel Quick Ref Guide Clin. 1994;(8):1-17.

Oelke M, Bachmann A, Descazeaud A, Emberton M, Gravas S, Michel MC, et al. EAU guidelines on the treatment and follow-up of non-neurogenic male lower urinary tract symptoms including benign prostatic obstruction. Eur Urol. 2013;64(1):118-40.

Gravas SJN, Cornu JN, Gacci M, Gratzke C, Herrmann TRW, Mamoulakis CRM, et al. EAU Guidelines presented at the EAU annual congress Amsterdam 2020. Available at: https://uroweb.org/ guidelines/. Accessed on 20 July 2020.

Blandy JP, Reynard JM, Notley R. Transurethral resection. 5th ed. United States: CRC Press; 2005.

Eziyi AK, Olajide AO, Asafa OQ, Ayomide OO, Oyeniyi AG, Ojewuyi OO. Preliminary experience with monopolar transurethral resection of prostate. IOSR-J Med Dental Sci. 2017;16(8):16-21.

Akpayak IC, Shuaibu SI, Onoma VE, Nabasu LE, Galam ZZ. Monopolar transurethral resection of the prostate for benign prostate hyperplasia: What are the outcomes and complication in our patients? Niger J Med. 2017;26:173-7.

Omodu OJ, Okengwu C, Gershon-Wali C. A three year review of the use of sterile water as an irrigation fluid for transurethral resection of the prostate (TURP). Int J Inno Med Health Sci. 2020;12:69-72.

Chukwujama NO, Oguike T, Azike J. Transurethral resection of the prostate a 3 year experience. Niger J Surg. 2011;17:15-8.

Young MJ, Elmussareh M, Morrison T, Wilson JR. The changing practice of transurethral resection of the prostate. Ann R Coll Surg Engl. 2018;100:326-9.

Memon A, Buchholz NP, Salahuddin S. Water as an irrigant in transurethral resection of the prostate: a cost-effective alternative. Arch Ital Urol Androl. 1999;71(3):131-4.

Alhasan S, Aji S, Mohammed AZ. Malami S. Transurethral resection of the prostate in Northern Nigeria, problems and prospects. BMC Urol. 2008;8:18.

Nesbit RM. Transurethral prostatic resection. In: Campbell L, Harrison J, eds. Urology. Philadelphia: Sounders; 1970;2479.

Agrawal M, Kumar M, Pandey S, Aggarwal A, Sankhwar S. Changing profiles of patients undergoing transurethral resection of the prostate over a decade: A single-center experience. Urol Ann. 2019;11(3):270-5.

Moorthy HK, Philip S. TURP syndrome-current concepts in the pathophysiology and management. Indian J Urol. 2001;17:97-100.