Retrospective Review of Outcomes of Open Retropubic Prostatectomy in Two centres in Abuja, Nigeria

Abstract

Background: Prostate cancer remains the most diagnosed cancer in Nigerian men despite the lack of national Prostate Specific Antigen (PSA)-based screening. Radical prostatectomy for early prostate cancer is not a commonly performed operation by urologists in our country. Objective: To report our experience with open radical retropubic prostatectomy in two tertiary hospitals in Abuja. Materials and Methods: Case notes and theatre records of all patients who underwent open radical retropubic prostatectomy at Federal Medical Centre, Abuja and National Hospital, Abuja between December 2021 and November, 2025 were retrospectively reviewed. Biodata, pre-operative parameters, intra-operative events and post-operative outcomes were documented and analyzed. Results: There was a total of 53 patients with a mean age of 60.7 years (range = 47 - 70) and preoperative PSA of 22.0ng/ml (range= 7.2 – 54). For the clinical stage, 83% had T1c disease. Lower urinary tract symptoms were reported by 52.2% of the patients while 47.8% were screen-detected. The duration of surgery, blood transfused, duration of admission and duration of catheterization averaged 3.5 hours, 2.2 pints, 9.1 days and 24.3 days respectively. The biopsy and specimen histopathology reports correlated in all cases.  Sixty-five percent of patients had ISUP grade groups 1 and 2 and 30.4% had adjuvant ADT. Biochemical recurrence was documented in 3 patients (5.7%). No death was recorded. Short -term and long-term complications documented include anastomotic leak (n=6,11.3%) and bladder neck stenosis (n=5, 9.4%) and urinary incontinence (n=4,7.5%) and erectile dysfunction (n=11, 20.8%) respectively. Conclusion: Open radical retropubic prostatectomy was a safe procedure with acceptable oncologic and functional outcomes in selected patients at the two centres. Erectile dysfunction remains one of the most bothersome morbidities.