Peri-operative blood transfusion in open suprapubic transvesical prostatectomy: relationship with prostate volume and serum total prostate specific aantigen (TPSA)

Abstract

Introduction: Open simple prostatectomy is the most effective and the most durable method of controlling symptoms associated with benign prostatic hyperplasia, especially in sub- Saharan Africa, where TURP set and expertise are unavailable in most health institutions. The risk of perioperative heterologous blood transfusion in open transvesical prostatectomy varies widely from one centre to another, and this risk is documented to improve over time in any given centre.

Aim: To determine the perioperative blood transfusion rate in our centre and to determine its relationship with the prostate volume estimated with transabdominal ultrasonography and serum total PSA.

Method: A retrospective study of patients surgically managed for BPH in 25 months (from March 2009 to March 2011).

Results: A total of 36 patients were included. Eighty-six percent of these patients had indwelling urinary catheter introduced earlier due to acute or chronic urinary retention, while 19.6% had macroscopic haematuria at presentation. The mean prostate volume was 90.4 cm3 (36-164), with 67% of cases having volumes greater than 70cm3. Ninety-one percent of the patients had serum tPSA greater than 4ng/ml (1.5-85.3 ng/ml, mean was 22.8ng/mL). The perioperative transfusion rate was 8.3% and it is not affected by the prostate volume (chi2(Yates) = 0.884), or serum total PSA (chi2(Yates) = 0.417). There was no perioperative mortality.

Conclusion: Open suprapubic transvesical prostatectomy is still a safe procedure; with a perioperative blood transfusion rate of 8.3% in our centre. This risk appears to be unrelated to preoperative prostate volume and serum tPSA.