REATMENT OUTCOME OF TRANS-VESICAL PROSTATECTOMY AND ASSOCIATED FACTORS AMONG PATIENTS ADMITTED WITH BENIGN PROSTATIC HYPERPLASIA IN PUBLIC HOSPITALS IN HARAR TOWN, EASTERN ETHIOPIA

Abstract

Background: Prostatectomy for patients with benign prostatic hyperplasia is one of the most frequent operations performed in the world. Transvasical prostatectomy may be safely performed in areas with poor socioeconomic condition by adequately trained surgeons who have no sufficient endoscopic equipment. In many parts of our country, patients do not usually admit for treatment until they have acute urinary retention, even though they have had diminishing caliber and strength of the urinary stream for months. So, Trasvesical prostatectomy is the only option and acceptable with a high degree of safety and efficacy in areas where the transurethral resection of prostate equipment is lacking like Ethiopia. Objective: To investigate the treatment outcome of transvesical prostatectomy among patients diagnosed with Benign Prostatic Hyperplasia at public hospitals in Harar town from December 10, 2021 to January 05, 2022. Methods: A facility-based cross-sectional (four years retrospective analysis) was conducted from December 10, 2021 to January 05, 2022 among 250 patients diagnosed with Benign Prostatic Hyperplasia in public hospitals in Harar town Eastern Ethiopia. Four years retrospective data (from September 1, 2017 to August 31, 2021). (Medical records of patients who undergone Transvesical Prostatectomy) were selected using simple random sampling technique. Structured questionnaire was used to extract pertinent data. Data were entered into EpiData version 3.1 and analyzed using Statistical package of social science (SPSS) version 22. Descriptive statistics was used to describe the data. A bivariable and multivariable logistic regression analyses was used to identify factors associated with outcome of trsvasical prpstatectomy. Adjusted odd ratio (AOR) (95% Confidence Interval) was used to report association and significance was declared at P-value <0.05. Results: The overall perioperative commlication was 19.2% [95%CI (17.1%-20.8%). The most common comorbidity was chronic hypertension. The commonest presenting complication was urinary retention at 58.8% (147/250) followed by recurrent urinary tract infection 17.2% (43/250). In the final model of multivariable analysis, predictor variables like: Patients’ age greater than 70years [AOR=5.18, 95CI (1.47-18.27), pre-existing comorbidity [AOR=5.94, 95%CI (1.62-21.75), and history of catheterization before surgery [AOR= 0.37, 95CI (0.18-0.76) were statistically associated with perioperative complication of Transvesical Prostatetectomy. Conclusion: In this study, the overall perioperative commlication of Transvesical Prostatetectomy is relatively low compared to national and regional findings. The most common comorbidity reported in this study was chronic hypertension. Advanced patients age, pre-existing comorbidities and history of catheterization before surgery were factors independently associated with perioperative Transvesical Prostatectomy. Therefore, due considerations should be given to those patients undergoing surgical procedures for Benign Prostate Hyperplasia who have pre existing comorbidities to minimize risk of perioperative Transvesical Protatectomy complication. Moreover, the emphasis should be given to elderly patients diagnosed with BPH to have better outcome of TVP.