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Erschienen in:
01.06.2015 | Original Article
A 30-year experience of Millin’s retropubic prostatectomy: Has this classic operation derived by a President of the College in Ireland stood the test of time?
Erschienen in: Irish Journal of Medical Science (1971 -) | Ausgabe 2/2015
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Introduction
In patients with large gland volume, open prostatectomy/adenoma enucleation remains a valuable surgical option in treating large obstructing prostates. We report our series of open prostatectomies spanning 32 years from a single institution.
Patients and methods
We retrospectively reviewed all patients who underwent open prostatectomy between 1980 and 2012. Patient demographical, clinical, pre- and postoperative data and final histology were retrieved from hospital in-patient enquiry system and chart review.
Results
A total of 161 patients underwent Millin’s prostatectomy by seven surgeons between 1980 and 2012. The mean blood loss was 1,381 mls (range 300–3,675 mls). One-third (34 %) of patients (n = 55) received a blood transfusion. The mean weight of prostate tissue removed was 119 g (median 112 g, range 17–372 g). 6.6 % of pathological specimens revealed incidental prostate cancer, of which 78 % were well differentiated (Gleason score ≤ 6). The mean weight of prostate tissue removed in patients who received a transfusion was 124 g. Trial of micturition (TOM) was performed at a mean of 9 days (median 9 days, range 5–25 days) with 94 % of patients having a successful trial of voiding. 6 % of cases early in the series failed to void initially, but did so at later removal of catheter while still in hospital. 45 patients (28 %) of patients developed peri- or postoperative complications. There were three deaths (1.9 %).
Conclusion
Open Millin’s prostatectomy popularized over half a century ago continues to be a valuable option for the surgical treatment of high-volume prostate glands with excellent outcomes for patients.