Post Transvesical Prostatectomy (TVP) Complications, Risk Assessment Using Clavien–Dindo System in Kassala Teaching Hospital, Kassala, Sudan

摘要

Background: Open surgery is the main treatment option for Large Volume (LV) BPH. We preferentially used a standardized system; the Clavien-Dindo grading system that was highly recommended by the European Association of Urology in 2014. The aim of this study was to identify the type and rate the complications following TVP. Methods: A prospective descriptive analytical study done in Kassala Teaching Hospital (Eastern Sudan) in a General Surgery Unit from January 2013 through December 2015. All patients [188] with a clinical problem of Benign Prostatic Hyperplasia (BPH) have been involved. Designed questionnaire was synchronously filled from the hospital records. Variables were: Age, ASA, Co-morbidities, Size of the prostate, Complications of BOO, duration of Catheterization pre-op, Duration of surgery, Hospital stay, Duration of irrigation, Removal of the catheter, Removal of the drain, renal impairment, Surgeon, Blood loss, SSI, Fistulae. Results: One hundred and eighty eight patients were included in the study over two years. Mean age 69.4 ± 8.5 SD. All the patients had a prostate > 80 ml by US scan. The size of the prostate has been categorized to 80-100 (135 patients 71.8%), 101-200 (48 patients 25.5%), and 201-250 (6 patients 3.2%). Complication rates according to Clavien-Dindo were 99 (52.6%) no complications, 81 (43%) grade II, 3 (1.6%) grade Iva, and 5 (2.6%) with grade V. Conclusion: Most complications occur in our setting is consistent with the literature except the SSI (Surgical Site Infection) rate. The Clavien-Dindo classification system promises to be a good system for assessing complications following prostatectomy. As a recommendation patients tracing for long term follow up of late complications, absence of national registry for most of them was a determinant limitation of our study.