Comparative study of extraperitoneoscopic adenomectomy and monopolar transurethral resection in surgical management of benign prostatic hyperplasia with prostate volume of 100-180 cm3


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Abstract

Introduction. Monopolar transurethral resection (M-TUR) is a standard for comparing various endoscopic techniques for benign prostatic hyperplasia (BPH), including extraperitoneoscopic adenomectomy (EA). Aim. To compare the effectiveness and safety of M-TUR and EA in the surgical management of BPH with a prostate volume of 100-180 cm3. Materials and methods. Medical records of 797 patients, who underwent surgery for BPH from 2011 to 2016, were retrospectively evaluated. The study comprised patients with a prostate volume of 100-180 cm3, who received either EA (group 1, n=34) or M-TUR (group 2, n=24). Results. The groups did not statistically significantly differ in age (69.3±6.9 vs 71.4±6.4 years in group and 2, p=0.328); complication rate (4 (11.7%) and 6 (25%), respectively, p=0.31); increase in the maximum urinary flow (10 ml/ s (Q1-Q3: 10.0-10.5), 13.5 ml/s (Q1-Q3: 7.5-17), respectively, p=0.538); postoperative hospital stay (11 (Q1-Q3: 10-14) and 10.5 (Q1-Q3: 8-17), respectively, p=0.875). There was statistically significant difference in operative time (190 and 82.5 min in the 1st and 2nd groups, respectively, p=0.041), and in blood loss (200 ml (Q1-Q3: 150-300) and 400 ml (Q1-Q3: 400-500), respectively, p=0.008). During 12 month follow-up, only 5 (20.8%) patients in the 2nd group (p=0.012) needed repeat surgery. Urinary incontinence of different severity at the time of discharge from hospital was also observed only in 4 (16.6%) patients the 2nd group (p=0.036). Conclusion. EA and M-TUR have similar safety and effectiveness in the surgical management of patients with BPH with the prostate volume of 100-180 cm3. EA is associated with longer operative time than M-TUR, but is accompanied by less blood loss, does not require repeat surgery, and confers less risk for urinary incontinence.

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About the authors

R. G Biktimirov

Federal Clinical Center for High Medical Technologies, FMBA of Russia, Moscow region; A.I. Burnazyan SSC FMBC, FMBA of Russia

Email: rafbik@kb119.ru
PhD Head of urology department of Federal clinical center of high medical technology

A. G Martov

A.I. Burnazyan SSC FMBC, FMBA of Russia

Email: martovalex@mail.ru
MD, professor Head of Department of Urology and Andrology

T. R Biktimirov

Federal Clinical Center for High Medical Technologies, FMBA of Russia, Moscow region; A.I. Burnazyan SSC FMBC, FMBA of Russia

Email: Gabastm@mail.ru
urologist at the Federal clinical center of high medical technology

D. I Marapov

Kazan State Medical University of Minzdrav of Russia

Email: damirov@list.ru
PhD, assistant of Department of social health and healthcare management

A. A Kaputovskij

Federal Clinical Center for High Medical Technologies, FMBA of Russia, Moscow region

Email: kaputovsky79@mail.ru
urologist at the Federal clinical center of high medical technology

References

  1. Gravas S., Bach T., Bachmann A., Drake M., Gacci M., Gratzke C., Madersbacher S., Mamoulakis C., Tikkinen K.A.O. «Guidelines on the Management of Non-Neurogenic Male Lower Urinary Tract Symptoms (LUTS), incl. Benign Prostatic Obstruction (BPO)». European Association of Urology 2015.
  2. Reich O., et al. Morbidity, mortality and early outcome of transurethral resection of the prostate: a prospective multicenter evaluation of 10654 patients. J. Urol. 2008;180(1):246-249.
  3. Gamal O.M., Gameel T.A., Ghoneem A., Soliman M.G. Perioperative use of cyproterone acetate with transurethral resection of large prostate: preliminary. J. Endourol. 2015;29(5) :569-574. Doi: 10.1089/ end.2014.0526.
  4. A-Hammouri F., Abu-Qamar A. Monopolar transurethral resection of the big prostate, experience at Prince Hussein Bin Abdullah Urology Center. Pak Med Assoc. 2011;61(7):628-631.
  5. Qian X., Yu G., Qian Y., Xu D., Liu H., Kong X., Zhu Y., Wang Z., Zheng J., Qi J. Efficacy of 5a-reductase inhibitors for patients with large benign prostatic hyperplasia (>80 mL) after transurethral resection of the prostate. Aging Male. 2015;18(4):238-243. doi: 10.3109/13685538.2015.1068750.
  6. Guo R.Q., Meng Y.S., Yu W., Zhang K. Suprapubic cystostomy versus nonsuprapubic cystostomy during monopolar transurethral resection of prostate: a propensity score-matched analysis. Asian J. Androl. 2017 Apr18. Doi:10.4103PMID: 28440263.
  7. Мартов А.Г., Лопаткин Н.А. «Руководство по трансуретральной эндоскопической электрохирургии доброкачественной гиперплазии простаты» Издательство «Триада-Х». 2006;144 с.
  8. Mitropoulos D., Artibani W., Graefen M., Remzi M., Rouprêt M., Truss M.C. Guidelines on Reporting and Grading of Complications after Urologic Surgical Procedures. European Association of Urology 2015.
  9. Reich O., Gratzke C., Stief C.G. Techniques and long-term results of surgical procedures for BPH. Eur Urol. 2006;49(6):970-978.
  10. Biktimirov R.G., Martov A.G., Biktimirov T.R., Kaputovskii A.A. The role of extraperitoneoscopic adenomectomy in the management of benign prostatic hyperplasia greater than 80 cm3. Urologiia. 2017;(6):76-81.

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