The immediate postoperative outcome of patients undergoing prostatectomy for benign prostatic hyperplasia at Kenyatta National Hospital
Objective: To describe the common postoperative complications of prostatectomy as seen at Kenyatta National Hospital. Materials and Methods: This is a prospective study of patients who underwent prostatectomy for benign prostatic hyperplasia at Kenyatta National Hospital between 6th October 2003 and 21 st June 2004. Main outcome measures: Age, co-morbidity, type of surgery, complications, reoperation, mortality, postoperative catheterisation, and duration of postoperative hospital stay. Results: A total of eighty five patients participated in the study, and their average age was 66 years. Open prostatectomy was the more common type of prostatectomy accounting for 81 % of cases while transurethral resection accounted for 19 % of cases. The most common intra-operative complication during prostatectomy was haemorrhage which occurred in ten patients (11.8 %). The most common postoperative complication following prostatectomy was wound sepsis occurring in 24 patients (35 %, n=69). Other postoperative complications observed were urinary tract infection (15 %), clot retention (10 %), pyrexia (10 %), and pneumonia (8.2 %). Three patients (4.4 %) required re-operation due to complications of postoperative wound sepsis. One patient had perforation of the bladder during transurethral resection and required a laparotomy to repair the bladder. Twenty six patients (30 %) had co- existing medical conditions. There was a significant association between wound sepsis and diabetes mellitus (p< 0.05). The mean duration of postoperative catheterisation was 6.66 days. There was a significant difference in the duration of postoperative catheterisation between open prostatectomy and transurethral resection (p= 0.001). The mean duration of postoperative hospital stay was 8.16 days. There was a significant difference in the duration of postoperative hospital stay between open prostatectomy and transurethral resection (p= 0.001). Conclusions: The duration of postoperative catheterisation and hospital stay are mainly determined by type of prostatectomy, and the presence of diabetes mellitus significantly increased the risk of developing postoperative wound sepsis.