Background: Prostate cancer, a disease common among elderly men, is often diagnosed at an advanced stage in resource-limited settings, when patients have developed bladder outlet obstruction (BOO). These patients commonly experience dysuria, urinary retention, high residual volume, and bladder stones, which seriously affect their daily lives. Palliative transurethral resection of the prostate (PTURP) is a surgical treatment option for advanced or metastatic prostate cancer. This study evaluates the results and the outcomes of patients with BOO due to advanced, metastatic prostate cancer who underwent PTURP at a single center in Douala.

Methods: This is a retrospective and descriptive study about 130 patients who underwent a palliative transurethral resection of the prostate from 2020 to 2025. The data were retrieved from patients’ clinical records. All patients had biopsy-confirmed prostate cancer and underwent PTURP at a single center, where all procedures were performed by the same urologist. Data were entered into Microsoft Excel 2019 and exported to R version 4.5.1 for statistical analysis.

Results: The participants’ median age was 64[57.2–70] years, with 36.92% of patients aged 62–71 years old. The most common clinical presentation was obstructive symptoms (44.62%). Approximately 86.92% of participants had at least one kind of metastasis, and 70% of them had high-grade cancer (Gleason score of 8–10). The surgery duration ranged from 15 minutes to 150 minutes, with a median value of 77.5[60–90] minutes. The duration of hospitalization was 2 days in 116(89.23%) participants and 3 days in 14(10.77%) participants. Postoperative complications occurred in 9 (6.92%) patients, and these were macroscopic hematuria, orchiepidydimitis, and suprapubic urinary catheter placement in three patients each. The median changes (preoperative – postoperative) in quality of life (QoL), international prostate symptom score (IPSS), maximum urinary flow rate (Qmax), and post-void residual volume were -3.5, -13.5, +12.5 ml/s, and -4.5 ml, respectively (all P<0.001).

Conclusion: PTURP is a safe, effective, and efficient minimally invasive procedure that significantly improves the quality of life of patients with advanced-stage, metastatic prostate cancer. It should routinely be considered for patients with bladder outlet obstruction.