THE OUTCOME OF SUPRAPUBIC PROSTATECTOMY - A CONTEMPORARY SERIES IN THE DEVELOPING-WORLD

Objectives. To assess the appropriateness of the technique of suprapub ic prostatectomy using a removable bladder neck partition suture for u se in a developing world hospital and to provide contemporary open pro statectomy outcome data currently lacking in the world's literature. M ethods. From 1984 to 1994, 240 consecutive patients presenting to a de veloping world hospital with acute urinary retention underwent suprapu bic prostatectomy using a removable bladder neck partition suture. The average length of time from bladder decompression until operation was 2.5 months. The outcome of these cases was retrospectively analyzed. Results. The overall early complication rate was 19.6%. There were no deaths. The transfusion rate was 4.6%. Clot retention occurred in 6.7% , and 2.9% required return to the operating room for evaluation. For t he second half of the series, the early complication rate decreased to 8.3%, the clot retention rate to 0.8%, and the transfusion rate to 1. 7%. Other early and late complications were minimal. The length of del ay from decompression until operation did not affect outcome. Conclusi ons. The technique of suprapubic prostatectomy using a removable bladd er neck partition suture is appropriate for use in developing world ho spitals because of its low morbidity and mortality rates. The outcome in this contemporary series of open prostatectomy cases compares favor ably with the outcome from reported contemporary transurethral resecti on of the prostate (TURF) series. These data demonstrate that suprapub ic prostatectomy is an acceptable option when the patient's anatomy or the state of local medical facilities precludes TURF.