Cargando…
‘Minimum-incision’ endoscopically assisted transvesical prostatectomy: Surgical technique and early outcomes
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,...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2014
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4435772/ https://www.ncbi.nlm.nih.gov/pubmed/26019954 http://dx.doi.org/10.1016/j.aju.2014.03.001 |
_version_ | 1782371966855938048 |
---|---|
author | El-Karamany, Tarek M. Al-Adl, Ahmed M. Abdel-Baky, Shabieb A. Abdel-Azeem, Abdallah F. Zaazaa, Mohamed A. |
author_facet | El-Karamany, Tarek M. Al-Adl, Ahmed M. Abdel-Baky, Shabieb A. Abdel-Azeem, Abdallah F. Zaazaa, Mohamed A. |
author_sort | El-Karamany, Tarek M. |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-4435772 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-44357722015-05-27 ‘Minimum-incision’ endoscopically assisted transvesical prostatectomy: Surgical technique and early outcomes El-Karamany, Tarek M. Al-Adl, Ahmed M. Abdel-Baky, Shabieb A. Abdel-Azeem, Abdallah F. Zaazaa, Mohamed A. Arab J Urol Stones/Endourology Original article 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. Elsevier 2014-09 2014-04-28 /pmc/articles/PMC4435772/ /pubmed/26019954 http://dx.doi.org/10.1016/j.aju.2014.03.001 Text en © 2014 Production and hosting by Elsevier B.V. on behalf of Arab Association of Urology. http://creativecommons.org/licenses/by-nc-nd/3.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/). |
spellingShingle | Stones/Endourology Original article El-Karamany, Tarek M. Al-Adl, Ahmed M. Abdel-Baky, Shabieb A. Abdel-Azeem, Abdallah F. Zaazaa, Mohamed A. ‘Minimum-incision’ endoscopically assisted transvesical prostatectomy: Surgical technique and early outcomes |
title | ‘Minimum-incision’ endoscopically assisted transvesical prostatectomy: Surgical technique and early outcomes |
title_full | ‘Minimum-incision’ endoscopically assisted transvesical prostatectomy: Surgical technique and early outcomes |
title_fullStr | ‘Minimum-incision’ endoscopically assisted transvesical prostatectomy: Surgical technique and early outcomes |
title_full_unstemmed | ‘Minimum-incision’ endoscopically assisted transvesical prostatectomy: Surgical technique and early outcomes |
title_short | ‘Minimum-incision’ endoscopically assisted transvesical prostatectomy: Surgical technique and early outcomes |
title_sort | ‘minimum-incision’ endoscopically assisted transvesical prostatectomy: surgical technique and early outcomes |
topic | Stones/Endourology Original article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4435772/ https://www.ncbi.nlm.nih.gov/pubmed/26019954 http://dx.doi.org/10.1016/j.aju.2014.03.001 |
work_keys_str_mv | AT elkaramanytarekm minimumincisionendoscopicallyassistedtransvesicalprostatectomysurgicaltechniqueandearlyoutcomes AT aladlahmedm minimumincisionendoscopicallyassistedtransvesicalprostatectomysurgicaltechniqueandearlyoutcomes AT abdelbakyshabieba minimumincisionendoscopicallyassistedtransvesicalprostatectomysurgicaltechniqueandearlyoutcomes AT abdelazeemabdallahf minimumincisionendoscopicallyassistedtransvesicalprostatectomysurgicaltechniqueandearlyoutcomes AT zaazaamohameda minimumincisionendoscopicallyassistedtransvesicalprostatectomysurgicaltechniqueandearlyoutcomes |