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‘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,...

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Autores principales: El-Karamany, Tarek M., Al-Adl, Ahmed M., Abdel-Baky, Shabieb A., Abdel-Azeem, Abdallah F., Zaazaa, Mohamed A.
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
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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.
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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
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