‘Minimum-incision’ endoscopically assisted transvesical prostatectomy: Surgical technique and early outcomes

El-Karamany, Tarek M. and Al-Adl, Ahmed M. and Abdel-Baky, Shabieb A. and Abdel-Azeem, Abdallah F. and Zaazaa, Mohamed A. (2014) ‘Minimum-incision’ endoscopically assisted transvesical prostatectomy: Surgical technique and early outcomes. Arab Journal of Urology, 12 (3). pp. 223-228. ISSN 2090-598X

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Abstract

Objective:
To describe the surgical technique and report the early outcomes of a ‘minimum-incision’ endoscopically assisted transvesical prostatectomy (MEATP) for managing benign prostatic obstruction secondary to a large (>80 g) prostate.

Patients and methods:
In a prospective feasibility trial, 60 men with large benign prostates underwent MEATP. The baseline and postoperative evaluation included the International Prostate Symptom Score (IPSS), a measurement of maximum urinary flow rate (Qmax), and the postvoid residual (PVR) urine volume. The adenoma was enucleated digitally through a 3-cm suprapubic skin incision, and haemostasis was completed with endoscopic coagulation of the prostatic fossa. Perioperative complications were recorded and stratified according to the modified Clavien–Dindo score.

Results:
The mean (SD, range) prostate weight estimated by ultrasonography was 102.9 (15.4, 80–160) g, the operative duration was 52 (8, 40–65) min, the haemoglobin loss was 2.1 (1, 0.4–5) g/dL, the catheterisation time was 5.2 (1.3, 4–9) days, and the hospital stay was 6.2 (1.4, 5–10) days. There were 21 complications recorded in 16 (27%) patients, and most (86%) were of grades 1 and 2. The most frequent complications were bleeding requiring a blood transfusion (8%), and prolonged drainage (5%). There was a significant improvement at 3 months after surgery in the IPSS (8.6 vs. 21.6, P < 0.001), Qmax (19.5 vs. 7.7, P < 0.001), and PVR (15.8 vs. 83.9 mL, P < 0.001).

Conclusion:
MEATP is feasible, safe and effective. Comparative studies and long-term data are required to determine its role in the surgical treatment of large-volume BPH.

Item Type: Article
Subjects: STM Digital > Medical Science
Depositing User: Unnamed user with email support@stmdigital.org
Date Deposited: 13 Jul 2023 04:37
Last Modified: 06 Jul 2024 08:03
URI: http://research.asianarticleeprint.com/id/eprint/1378

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