The Impact of Epidural Anaesthesia and Analgesia on Patient-Centered Outcomes Following Open Prostatectomy for Benign Prostatic Hyperplasia

Evidence from studies indicate that epidural anesthesia and analgesia (EAA) improves post operative recovery and outcomes following open retropubic radical prostatectomy for organ confined prostate cancer. Literature is sparse on such improvements following open prostatectomy for benign prostatic hyperplasia (BPH). This study aims to fill that gap. Methods: A prospective study of patients who had open prostatectomy for (BPH) under EAA (Group A) and those who had other forms of anesthesia (Group B) between January 2017 and December 2023 in the Urology department of a tertiary hospital was undertaken. Immediate postoperative outcome data recorded for each patient were number of pints of blood transfused, total irrigation fluid volume, pain scores, bladder spasms count, episodes of blocked catheters, and weight of prostatic adenoma enucleated. Results: There were 46 patients divided into 25 and 21 for groups A and B respectively. Post operative blood loss, as estimated by average number of pints of blood transfused and total volume of irrigation fluid was significantly higher for group B than A patients (3.05 ± 1.28 vs 0.92 ± 0.86 pints and 51.74 ± 15.72 vs 24.96 ± 5.74 liters respectively; P<0.001). Episodes of blocked catheter and bladder spasms were also significantly lower for group A than B patients(P<0.001). Expectedly, post operative pain scores was higher for group B patients (5.19 ± 1.34 vs 1.44 ± 1.00 for group A; p<0.001). Average weight of enucleated adenoma for both groups was 107.8 ± 55.4 and 132.1 ± 69.2 respectively (P=0.192). Conclusion: Post operative epidural analgesia significantly reduced the pain, the spasm, the bleed, the block and flush, commonly associated with open prostatectomy for BPH in the immediate postoperative period.