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Feasibility of Open Simple Prostatectomy with early
Vascular Control Purpose: To describe open simple prostatectomy performed by applying lateral capsular transfixing sutures after adenoma enucleation and minimum operative haemorrhage. Methods: Between April 1996 and December 2004, four hundred and twenty five (425) patients presented to the urology clinic at the University Teaching Hospital, Lusaka with symptomatic BPH. After adenomectomy transfixing sutures were placed from 3 to 9 o’clock positions around the prostatic capsule. To determine intra-operative and post-operative haemorrhage we measured haematocrit and haemoglobin 12 hours after the surgery. We also measured the amount of blood in the suction bottle. The duration of visible post-operative haemorrhage was monitored via the Foley catheter. Results: There was no intra-operative death. There was no blood transfusion for any of the 425 patients. Average pre-operative and post-operative haemoglobin was 13.7 and 12.3 gm./dl. Respectively. The median decrease was 1.85gm./dl. Respective. Average intra-operative blood loss was 125 cc and average decrease in haematocrit was 3.2%. Conclusion: The haemostatic technique with extra capsular prostatic adenomectomy results in less bleeding. This technique is very suitable in our set up in Africa where there is no availability of endoscpic equipments and there are no experienced urologists. This technique can also be taught to the post-graduate students. There are no blood transfusion avoiding the hazards of blood transfusion like HIV disease and hepatitis. |
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