Afenigus Abebe Dilie, Kassahun Berhanu, Dessalegn Megbar, Getnet Asmamaw, Gedfew Mihretie, Kebede Tiringo
Department of Nursing, College of Medicine and Health Sciences, Debre Markos University, P. O. Box 269, Debre Markos, Gojjam, Ethiopia.
Department of Surgery, College of Medicine and Health Sciences, Debre Markos University, P.O. Box 269, Debre Markos, Gojjam, Ethiopia.
Eur J Med Res. 2024 Dec 26;29(1):629. doi: 10.1186/s40001-024-02249-w.
Benign prostatic hyperplasia (BPH) is non-cancerous growth of the prostate gland which surrounds the urethra. For men with BPH who are older than 50, a prostatectomy is a common surgical procedure. Open prostatectomy is still more prevalent in regions with limited access to advanced surgical procedures like transurethral resection of the prostate and robotic-assisted laparoscopic prostatectomy. Determining prostatectomy outcomes for BPH and associated factors is essential to optimize patient care and improve awareness of this condition. However, the outcomes of prostatectomy and associated factors are not studied in Ethiopia.
To assess prostatectomy outcomes for patients with benign prostatic hyperplasia and its associated factors in East and West Gojjam Zones, 2021.
A facility-based cross-sectional study was employed among 412 patients with prostatectomy using systematic sampling. Five-year secondary data from 2016 to 2021 data was extracted from patients' medical records using a structured proforma. The outcomes of prostatectomy for BPH are categorized into good outcomes if significant symptom relief such as reduced urinary frequency, urgency, and nocturia and preserved sexual function using International Prostate Symptom Scores and Sexual Health Inventory for Men. A poor outcome involves minimal symptom improvement, recurrence of symptoms, severe complications like urinary incontinence or retention, and erectile dysfunction. Besides this, logistic regression models were computed to assess the relationship between variables.
Among 412 patients with prostatectomy, 68 (16.5%; 95% CI 12.9-20.1) had poor outcomes, and 344 (83.5%; 95% CI 79.9-87.1) had good outcomes. In addition, patients who took venous thromboembolism (VTE) prophylaxis were 80% less likely to develop good prostatectomy outcomes than those who did not take prophylaxis (AOR = 0.2; 95% CI 0.07-0.6). Good prostatectomy outcomes were 86% lower in those who did not obtain the proper wound care than in those who did (AOR = 0.14; 95% CI 0.03-0.6). Comparably, patients with hypertension comorbidity were 70% (AOR = 0.3; 95% CI 0.1-0.6) less likely to have good prostatectomy outcomes. On the other hand, patients who underwent transurethral resection of the prostate (TURP) had twice the odds of a good prostatectomy outcome compared to those who underwent transvesical prostatectomy (TVP) (AOR = 2; 95% CI 1.5-5.4). Moreover, patients who received preoperative oral medical therapy for benign prostatic hyperplasia (BPH) were twice as likely to experience poor prostatectomy outcomes compared to those who did not take preoperative medical therapy (AOR = 2; 95% CI 1.2-8.7). Similarly, patients with a prostate volume of 100-200 cm were five times more likely to develop poor prostatectomy outcomes compared to those with a prostate volume of 30-60 cm (AOR = 5; 95% CI 2.3-10).
A total of 16.5% of the participants experienced poor outcomes following prostatectomy. The factors associated with these outcomes included venous thromboembolism prophylaxis intake, appropriate wound care, hypertension as a comorbidity, surgical modality, preoperative oral medication therapy for BPH, and prostate volume.
良性前列腺增生（BPH）是前列腺围绕尿道的非癌性生长。对于50岁以上的BPH男性患者，前列腺切除术是一种常见的外科手术。在难以获得先进手术（如经尿道前列腺切除术和机器人辅助腹腔镜前列腺切除术）的地区，开放性前列腺切除术仍然更为普遍。确定BPH前列腺切除术的结果及其相关因素对于优化患者护理和提高对这种疾病的认识至关重要。然而，埃塞俄比亚尚未对前列腺切除术的结果及其相关因素进行研究。
评估2021年戈贾姆东、西区良性前列腺增生患者前列腺切除术的结果及其相关因素。
采用基于机构的横断面研究，对412例接受前列腺切除术的患者进行系统抽样。使用结构化表格从患者的病历中提取2016年至2021年的五年二次数据。根据国际前列腺症状评分和男性性健康量表，BPH前列腺切除术的结果如果有显著的症状缓解，如尿频、尿急和夜尿减少以及性功能保留，则分类为良好结果。不良结果包括症状改善最小、症状复发、严重并发症（如尿失禁或尿潴留）和勃起功能障碍。此外，计算逻辑回归模型以评估变量之间的关系。
在412例接受前列腺切除术的患者中，68例（16.5%；95%CI 12.9 - 20.1）结果不良，344例（83.5%；95%CI 79.9 - 87.1）结果良好。此外，接受静脉血栓栓塞（VTE）预防的患者前列腺切除术结果良好的可能性比未接受预防的患者低80%（调整后比值比[AOR]=0.2；95%CI 0.07 - 0.6）。未获得适当伤口护理的患者前列腺切除术结果良好的可能性比获得适当伤口护理的患者低86%（AOR = 0.14；95%CI 0.03 - 0.6）。相比之下，合并高血压的患者前列腺切除术结果良好的可能性低70%（AOR = 0.3；95%CI 0.1 - 0.6）。另一方面，接受经尿道前列腺切除术（TURP）的患者前列腺切除术结果良好的几率是接受经膀胱前列腺切除术（TVP）患者的两倍（AOR = 2；95%CI 1.5 - 5.4）。此外，接受BPH术前口服药物治疗的患者前列腺切除术结果不良的可能性是未接受术前药物治疗患者的两倍（AOR = 2；95%CI 1.2 - 8.7）。同样，前列腺体积为100 - 200 cm的患者前列腺切除术结果不良的可能性是前列腺体积为30 - 60 cm患者的五倍（AOR = 5；95%CI 2.3 - 10）。
共有16.5%的参与者在前列腺切除术后出现不良结果。与这些结果相关的因素包括静脉血栓栓塞预防措施的使用、适当的伤口护理、合并高血压、手术方式、BPH术前口服药物治疗以及前列腺体积。
