Aira Hospital

Benign enlargement of the prostate is as common in Ethiopia as in the western world. For some - still unknown – reason the glands in the prostate grow large and compress the normal prostatic tissue causing difficulties in passing urine. This is called Benign Prostatic Hyperplasia (BPH) in medical terms, and the surgery done to relieve it is called a prostatectomy. As often in the medical world, the terminology is not strictly correct. Literally it means “removing the prostate”, but what is actually done at surgery is an enucleation of the enlarged glands, the adenoma. So “adenoma enucleating” would be a more appropriate term.

Often the patient - always an elderly gentleman with gray hair and cataract - arrives in severe agony with a huge, distended bladder due to acute retention of urine.

 

Catheterization gives immediate relief. If the patient is ready financially, he will be operated immediately without delay. Other colleagues claim that the surgery should be postponed for a certain period of time after a spell with acute retention; an arbitrary period of 6 weeks is often mentioned. However we have not experienced any complication due to this active treatment policy

 

Other comes with an indwelling catheter since shorter or longer time.

 

This unfortunate patient presented himself with a suprapubic catheter since 6 years. He couldn’t  afford the surgery needed at that time, and it took him 6 years to save enough money to return for the  most needed surgery

 

In the western world the adenoma is removed with an instrument inserted into the bladder via the penis as a routine. This technique has quite recently been introduced at the Black Lion University Hospital and some private institutions in Addis Abeba. However out here in the countryside the patients come late for surgery when the prostate adenoma is too large to be removed by that modern technique.

After surgery, whatever technique being used, there is always a risk of urinary incontinence, often only temporary, sometimes permanent. A penis clamp has then to be provided to prevent dripping of urine. One clever patient made his own clamp.

 

 

 

 

 

 

 

I use hair slides which can be purchased at the local market. Since the colorful decoration is not always appreciated, I remove that before applying the clamp to the unfortunate patient.

At the market	Hair slides at sale
The hair slide	In use  - without decoration

 

 

At Aira Hospital the following two methods has been used:

1)      PERINEAL PROSTATECTOMY – see that page

2)      TRANSVESICAL PROSTATECTOMY – see that page