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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?

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Abstract

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.

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Authors and Affiliations

  1. Department of Urology, The Adelaide and Meath Incorporating the National Children’s Hospital (AMNCH), Tallaght, Dublin 24, Ireland

    R. M. Long, A. Z. Thomas, C. Browne, M. Alsinnawi, J. Ul-islam, T. E. D. McDermott, R. Grainger & J. A. Thornhill

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  1. R. M. Long
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  2. A. Z. Thomas
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  3. C. Browne
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  4. M. Alsinnawi
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  5. J. Ul-islam
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  6. T. E. D. McDermott
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  7. R. Grainger
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  8. J. A. Thornhill
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Correspondence to A. Z. Thomas.

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Long, R.M., Thomas, A.Z., Browne, C. et al. 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?. Ir J Med Sci 184, 341–344 (2015). https://doi.org/10.1007/s11845-014-1115-2

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  • DOI: https://doi.org/10.1007/s11845-014-1115-2

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