OUTLOOK OF MILLIN’S PROSTATECTOMY
Objective: To evaluate the short term complications and cost-effectiveness of Millin’s prostatectomy.
Materials and methods: Fifty patients of benign prostatic hyperplasia (>80 gms of prostate) with signs and symp-
toms of bladder outlet obstruction were included in this study (during 12 months i.e. November 1st
, 2004 to October
2005). All patients planned for retropubic prostatectomy were those admitted in Surgical B unit of the Lady
Reading hospital Peshawar. After informed consent from all patients for clinical examination and investigations, the
diagnosis was made on the basis of history, digital rectal examination and ultrasonography which was used to
assess the back pressure effects (bilateral hydroureter and hydronephrosis and bladder wall thickness), prostate
size and volume of residual urine. Cystoscopy was done in all cases to rule out pathology other than BPH. For the
patients to be included in the study they had to have benign prostatic hyperplasia (>80 gms of prostate) on ultra-
sonography and signs and symptoms of bladder outlet obstruction as determined by digital rectal examination.
Patients having; smaller prostate size and manageable with TURP, uraemia, past history of prostate surgery, Ca
prostate and bladder pathology were not considered as participants of this study. Data were collected using using a
proforma and analyzed using SPSS version 10.
Results: Two (4%) patients had clot retention which was relieved by washing through the urethral catheter with
normal saline. Three (6%) patients had transient incontinence managed by reassurance and pelvic floor muscle
strengthening exercises, with no residual incontinence after 06 weeks of surgery. Three (6%) patients had superficial
wound infections which were treated with antibiotic after culture and sensitivity. Two (4%) patients developed
epididymo-orchitis within 2-3 weeks of surgery, which were treated conservatively with antibiotic. No operative or
post operative mortality occurred.
Conclusion: The findings of this work indicate retropubic prostatectomy as an acceptable procedure. Complications
if any could be managed with minimum number of normal saline drips for bladder wash with reduced patients stay
Key words: Millin’s Prostatectomy, Benign prostatic hyperplasia.