Modified Suprapubic Prostatectomy Without Irrigation Is Safe
Received 7 April 2009; accepted 28 June 2009. published online 16 November 2009.
Objectives
To determine whether postoperative bladder irrigation can be safely eliminated in the context of a modification to surgical technique. Post-operative irrigation is routinely used following suprapubic prostatectomy for benign prostatic hyperplasia (BPH).
Methods
Single center retrospective study of 82 patients who underwent suprapubic prostatectomy for BPH comparing complications in those treated with irrigation to patients treated with surgical modification and no irrigation. These consecutive patients were divided into 2 groups: group 1 consisted of 43 patients who underwent suprapubic prostatectomy before June 2006 with post operative bladder irrigation and standard method of surgical hemostasis. Group 2 consisted of 39 patients who underwent suprapubic prostatectomy after June 2006 with no post operative irrigation and a modified bladder neck repair performed with the intent of improving hemostasis. The modified bladder neck repair is described.
Results
Patient characteristics and prostate specimen weights are comparable in both groups. Clot retention was more common in the group 1 patients (11 patients in group 1 vs 2 patients in group 2, P = .01), and 2 patients with disruption of the anterior bladder wall closure were in group 1.
Conclusions
Suprapubic prostatectomy can be safely performed without the use of postoperative irrigation. The elimination of postoperative irrigation significantly reduces the economic burden on patients in our locality.
aPan African Academy of Christian Surgeons, Banso Baptist Hospital, Kumbo, NWP, Cameroon
bDepartment of Biostatistics, University of Texas M. D. Anderson Cancer Center, Houston, Texas
cDepartment of Urology, University of Texas M. D. Anderson Cancer Center, Houston, Texas
ABSTRACT