Bleeding prostate: A 10-year experience in the University of Maiduguri Teaching Hospital (Umth), Nigeria

Background: Bleeding from an enlarged prostate gland is a major complication of benign prostatic enlargement (BPH). This review details our management over a 10-year period. Materials and Methods: A retrospective review of patients who presented with bleeding BPH between January 2001 and December 2010 was carried out to determine the outcome of management. Results: Forty-two patients with bleeding prostates treated by open prostatectomy were analyzed. The peak incidence was in the age group of 60-69 years. The main associated co-morbidities were hypertension in 17 (40.48%) and diabetes in seven (16.67) patients. Urine culture was positive in 24 (57.14%) patients, with E. coli in 13 (54.17%) and Pseudomonas in four (16.67%) patients as the main isolates. Most patients (37; 88.08%) received blood transfusions ranging from two to four units. Operative techniques were transvesical in 30 (76.92%) and retropubic in nine (23.08%) patients. Isolated median lobe enlargement of the prostate was seen in 18 (46.15%) and whole organ enlargement in 21 (53.85%) patients. The weight of the prostates ranged from 47 to 403 g (mean, 127 g). Incidental carcinoma was seen in one patient (2.56%). The mean hospital stay was 11 days (range 9-21), and the mean follow-up was 21 months (range 3-26). There was one (2.38%) mortality. Conclusion: BPH with massive hematuria invariably has an enlarged median lobe and is managed by open prostatectomy, without risk of re-bleeding.