Surgical Management of Benign Prostatic Hyperplasia at Lagos State University Teaching Hospital: An Outcomes Audit

Benign prostatic hyperplasia (BPH) is the most common cause of lower urinary tract symptoms in older Nigerian men, and surgical management remains the definitive intervention for patients failing medical therapy. This outcomes audit evaluates surgical management practices for BPH at Lagos State University Teaching Hospital (LASUTH), Ikeja, Lagos State, South West Nigeria, from 2020 to 2023. Case records of 160 men who underwent transurethral resection of the prostate (TURP) or open prostatectomy were reviewed. Outcomes assessed included postoperative urinary flow rates, symptom scores using the International Prostate Symptom Score (IPSS), operative complications, and hospital stay duration. Open prostatectomy was performed in 58% of cases, predominantly for prostates exceeding 80 grams. TURP was associated with shorter hospital stays (mean 2.4 days versus 6.1 days) and lower bleeding complications. Significant symptom improvement (>50% reduction in IPSS) was achieved in 84% of TURP patients and 79% of open prostatectomy patients. TUR syndrome occurred in 3 TURP cases. The study recommends expanding TURP capacity through equipment investment and surgeon training at LASUTH, and advocates for structured decision-making algorithms based on prostate volume to guide surgical approach selection in South West Nigeria. Keywords: benign prostatic hyperplasia, TURP, prostatectomy, LASUTH, urological outcomes