INTRODUCTION: In patients with large gland volume, open prostatectomy/adenoma enucleation remains a valuable surgical option in treating large obstructing prostates.
We report our series of open prostatectomies spanning 32 years from a single institution.
PATIENTS AND METHODS: We retrospectively reviewed all patients who underwent open prostatectomy between 1980 and 2012. Patient demographical, clinical, pre- and postoperative data and final histology were retrieved from hospital in-patient enquiry system and chart review.
RESULTS: A total of 161 patients underwent Millin's prostatectomy by seven surgeons between 1980 and 2012. The mean blood loss was 1,381 mls (range 300-3,675 mls). One-third (34 %) of patients (n = 55) received a blood transfusion. The mean weight of prostate tissue removed was 119 g (median 112 g, range 17-372 g). 6.6 % of pathological specimens revealed incidental prostate cancer, of which 78 % were well differentiated (Gleason score ≤ 6). The mean weight of prostate tissue removed in patients who received a transfusion was 124 g. Trial of micturition (TOM) was performed at a mean of 9 days (median 9 days, range 5-25 days) with 94 % of patients having a successful trial of voiding. 6 % of cases early in the series failed to void initially, but did so at later removal of catheter while still in hospital. 45 patients (28 %) of patients developed peri- or postoperative complications. There were three deaths (1.9 %).
CONCLUSION: Open Millin's prostatectomy popularized over half a century ago continues to be a valuable option for the surgical treatment of high-volume prostate glands with excellent outcomes for patients.
Written by:
Long RM, Thomas AZ, Browne C, Alsinnawi M, Ul-Islam J, McDermott TE, Grainger R, Thornhill JA. Are you the author?
Department of Urology, The Adelaide and Meath Incorporating the National Children's Hospital (AMNCH), Tallaght, Dublin 24, Ireland.
Reference: Ir J Med Sci. 2014 Apr 13. Epub ahead of print.
doi: 10.1007/s11845-014-1115-2
PubMed Abstract
PMID: 24729021
UroToday.com Prostate Cancer Section
