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. 2014 Sep;12(3):223-8.
doi: 10.1016/j.aju.2014.03.001. Epub 2014 Apr 28.

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

Tarek M El-Karamany  1 , Ahmed M Al-Adl  1 , Shabieb A Abdel-Baky  1 , Abdallah F Abdel-Azeem  1 , Mohamed A Zaazaa  1
Affiliations

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

Tarek M El-Karamany et al. Arab J Urol. 2014 Sep.

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 (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.

Keywords: BPO, benign prostatic obstruction; Benign prostatic hyperplasia; Endoscopy; HoLEP, holmium laser enucleation of the prostate; MEATP, ‘minimum-incision’ endoscopically assisted transvesical prostatectomy; Minimum incision; OP, open prostatectomy; PVR, postvoid residual urine volume; Prostatectomy; Qmax, maximum urinary flow rate; STEP, single-port transvesical enucleation of the prostate; VAPS, visual analogue pain scale.

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Figures

Figure 1
Figure 1
The skin incision used for access to remove large prostatic adenomas.
None
See this image and copyright information in PMC

References

    1. Tubaro A., de Nunzio C. The current role of open surgery in BPH. EAU-EBU Update Ser. 2006;4:191–201.
    1. Ou R., You M., Tang P., Chen H., Deng X., Xie K. A randomized trial of transvesical prostatectomy versus transurethral resection of the prostate for prostate greater than 80 mL. Urology. 2010;76:958–961. - PubMed
    1. Kuntz R.M., Lehrich K., Ahyai S.A. Holmium laser enucleation of the prostate versus open prostatectomy for prostates greater than 100 g: 5-year follow-up results of a randomized clinical trial. Eur Urol. 2008;53:160–168. - PubMed
    1. Abdel-Hakim A.M., Habib E.I., El-Feel A.S., Elbaz A.G., Fayad A.M., Abdel-Hakim M.A. Holmium laser enucleation of the prostate: initial report of the first 230 Egyptian cases performed in a single centre. Urology. 2010;76:448–452. - PubMed
    1. Sotelo R., Spaliviero M., Garcia-Segui A., Hasan W., Novoa J., Desai M.M. Laparoscopic retropubic simple prostatectomy. J Urol. 2005;173:757–760. - PubMed