Radical retropubic prostatectomy by laparoscopic approach versus open surgery for localized prostate cancer. Techniques and results in two Cameroonian university teaching hospitals

Abstract

Introduction: Prostate cancer is a significant global health issue. The aim of our study was to analyse the short and medium-term outcomes of laparoscopic and open retropubic radical prostatectomy in two Cameroonian Teaching Hospitals.

Methods: We conducted a retrospective and prospective analysis of all patients who underwent radical retropubic prostatectomy (RRP) and radical laparoscopic prostatectomy (RLP) in the Urology and Andrology Departments of the Yaoundé Central and Douala Laquintinie Hospitals over a 14-year period (2010-2024). We used validated self-administered questionnaires, including International Consultation Incontinence Questionnaire (ICIQ) and International Index of Erectile Function (IIEF 5) to assess perioperative data, disease progression and the quality of life.

Results:  totally, 17 patients underwent radical prostatectomy, of which 10 patients had open PRR and 7 had a PRL. Their mean age was 66.1, with majority being from four regions of Cameroon. The period between diagnosis and surgery was 4.3 months. Participants who had open surgery had a higher blood transfusion rate (80% vs 28.7%; p= 0.001); longer catheter and drain removal time (13.1 vs. 11.7 days; 6.3 vs 4.2 days); and longer hospital stay (15.8 vs. 8.2 days). Mid-term complications were comparable in both groups, with erectile dysfunction representing 50% for PRR vs 42.8% for PRL (p = 0.33) and urinary incontinence was present in 10% for PRR vs 28.5% for PRL (p= 0.1).

Conclusion: Surgical treatment for localized prostate cancer provides adequate carcinologic control in our setting. Open surgery had more peri-operative complications, medium term outcomes showed no significant differences between both approaches.