title: SURGICAL MANAGEMENT OF BPH IN GHANA: A NEED TO IMPROVE ACCESS TO TRANSURETHRAL RESECTION OF THE PROSTATE.
abstract: BACKGROUND
  Open prostatectomy for benign prostate hyperplasia (BPH) is widely practiced in Ghana and Africa. Some of the reasons include lack of expertise and facilities for Transurethral Resection of the Prostate (TURP) and digital rectal examination assessment of prostates as greater than 50 grams.
  
  
  OBJECTIVE
  To assess the prostate volumes of patients for surgical management of BPH by transrectal ultrasound (TRUS) and to determine, on the basis of prostatic volume, what percentage of those who had open prostatectomy could have been managed by TURP.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  The Korle Bu Teaching Hospital, Accra, Ghana.
  
  
  METHODS
  Patients for elective surgical management of BPH from March to September 2010 were studied.
  
  
  RESULTS
  Fifty-eight. patients had surgical management of BPH. Forty-six of them (79.3%) had open prostatectomy whilst twelve (20.7%) had TURP with a mean age of 70.4 and 65.2 years respectively. The most common reason for the open prostatectomy was refractory retention of urine (76.0%) while that for TURP was lower urinary tract symptoms (58.3%). The mean prostate volume for the patients who had open prostatectomy was 64.2ml ± 28.7mls (range 23.0-121.0ml) while that of the TURP group was 40.1g ± 16.2mls (range 18.5-70.0mls). Of the open prostatectomy group, 67.4% of them had prostate volumes 75 mls or less. The blood transfusion and peri-operative complication rates for the open prostatectomy and TURP groups were 13% versus 8.3% and 8.7% versus 8.3% respectively. There was no mortality.
  
  
  CONCLUSIONS
  Access to TURP in the surgical management of BPH in Ghana is low (20.7%). With improved facilities including routine use of TRUS for assessing prostate size and availability of expertise for TURP, 67.4% of patients offered open prostatectomy presently could benefit from TURP, using prostate volumes 75mls (75g) or less as indication for TURP.
authors: Department of Surgery and Urology, University of Ghana medical School, Accra, Ghana.
authors: M Y
authors: MY
authors: Kyei
authors: J E
authors: JE
authors: Mensah
authors: B
authors: B
authors: Morton
authors: S
authors: S
authors: Gepi-Attee
authors: G O
authors: GO
authors: Klufio
authors: E D
authors: ED
authors: Yeboah
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001803:Blood Transfusion; D051517:Digital Rectal Examination; D017558:Elective Surgical Procedures / Q000379:methods; D005869:Ghana; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011468:Prostatectomy / Q000379:methods; D011470:Prostatic Hyperplasia / Q000601:surgery*; D020728:Transurethral Resection of Prostate / Q000379:methods; D016896:Treatment Outcome