'Minimum-incision' endoscopically assisted transvesical prostatectomy: Surgical technique and early outcomes.

Autor:	El-Karamany TM; Benha Faculty of Medicine, Benha, Egypt., Al-Adl AM; Benha Faculty of Medicine, Benha, Egypt., Abdel-Baky SA; Benha Faculty of Medicine, Benha, Egypt., Abdel-Azeem AF; Benha Faculty of Medicine, Benha, Egypt., Zaazaa MA; Benha Faculty of Medicine, Benha, Egypt.
Jazyk:	angličtina
Zdroj:	Arab journal of urology [Arab J Urol] 2014 Sep; Vol. 12 (3), pp. 223-8. Date of Electronic Publication: 2014 Apr 28.
DOI:	10.1016/j.aju.2014.03.001
Abstrakt:	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 (Q max), 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), Q max (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.
Databáze:	MEDLINE
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