title: An appraisal of a technical modification for prevention of bladder neck stenosis in retropubic prostatectomy: An initial report.
abstract: OBJECTIVE
  To report the experience with our technical modification of the trigone-bladder neck complex management in the prevention of bladder neck stenosis (BNS) following open simple retropubic prostatectomy.
  
  
  METHODS
  It was a retrospective review of data of patients that underwent open simple retropubic prostatectomy with technical modification of the trigone-bladder neck complex in two Nigerian tertiary hospitals, by a single surgeon, from January 2007 to December 2011. The data analysed included the demographic variables, the modes of presentation, need for blood transfusion, duration of catheterization and the duration of hospital stay. The primary end-point was the development or otherwise of BNS.
  
  
  RESULTS
  Eighty-seven patients' data were available for analysis from a total of 91 patients. The mean age (±standard deviation [SD]) was 65.14 years (±10.55). Preoperative urinary retention was present in 58% of the patients. The maximal flow rate (Qmax) was 12.05 ml/s among the 20 patients that had preoperative uroflowmetry. The transfusion rate was 35%, but almost two-third of them had only one unit of blood transfused. The mean weight (±SD) of the enucleated adenoma was 82.64 g (±36.63). Bladder irrigation was required in 14% of the patients, majority of the patients had urethral catheter removed after 96 h and the mean hospital stay was 6.52 days. No patient developed BNS after a mean follow-up duration of 16.39 months.
  
  
  CONCLUSIONS
  Bladder neck stenosis can be a distressing complication of prostatectomy. The result of our technical modification of managing the trigone-bladder-neck complex looks promising for prevention or delaying the onset of BNS. A long-term observation and a prospective randomised control trial to ascertain this initial experience is needed.
authors.affiliation: Department of Surgery, Division of Urology, University of Ilorin, Ilorin, Nigeria.
authors.forename: Abdulwahab Akanbi
authors.initials: AA
authors.lastname: Ajape
authors.affiliation: Department of Surgery, Division of Urology, University of Ilorin, Ilorin, Nigeria.
authors.forename: Sulyman Alege
authors.initials: SA
authors.lastname: Kuranga
authors.affiliation: Department of Surgery, Division of Urology, University of Ilorin, Ilorin, Nigeria.
authors.forename: AbdulLateef
authors.initials: A
authors.lastname: Babata
authors.affiliation: Department of Surgery, Federal Teaching Hospital, Gombe, Nigeria.
authors.forename: Mustapha Mohammed
authors.initials: MM
authors.lastname: Kura
authors.affiliation: Department of Surgery, Division of Urology, University of Ilorin Teaching Hospital, Ilorin, Nigeria.
authors.forename: Jibril O
authors.initials: JO
authors.lastname: Bello
keywords: Benign prostatic obstruction; bladder neck stenosis; retropubic prostatectomy; technical modification; trigone-bladder neck complex
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