COMPARATIVE ASSESSMENT OF TREATMENTS FOR PROSTATE ADENOMA GREATER THAN 100 CM3


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Resumo

Aim. To compare holmium laser enucleation of the prostate (HoLEP) and endovideosurgical (EVS) adenomectomy in the treatment of prostate adenoma. Materials and methods. We compared treatment results of 180 patients with prostate adenomas greater than 100 cm3 who underwent EVS adenomectomy (n=90) and laser enucleation of the prostate (n=90). The analysis included the following parameters: duration of catheterization, length of postoperative hospital stay, I-PSS score, maximum urinary flow rate measured by uroflowmetry and complications according to Clavien-Dindo grading systems. Results. There were no significant differences in patient age, preoperative prostate size, glandular tissue weight, and operative time. The duration of catheterization (p=0.0008) and length of postoperative hospital stay (p<0.0001) were significantly shorter in the HoLEP group. Both groups showed a statistically significant improvement in functional performance at three months post-surgery. Complications in the HoLEP and EVS adenomectomy group occurred in 18 (20%) and 23 (25.55%) patients, respectively (p>0.99). Conclusion. The two methods mentioned above are widely used in the treatment of prostate adenoma. However, holmium laser enucleation of the prostate shows similar short-term functional results and complication rates compared with EVS adenomectomy for prostate adenomas greater than 100 cm3. The patients ofthe HoLEP group had better results regarding the duration of catheterization and length of postoperative hospital stay. Therefore, laser enucleation is the preferred surgical modality for prostate adenomas greater than 100 cm3.

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Sobre autores

I. Orlov

St. Luke’s Clinical Hospital

Email: doc.orlov@gmail.com
Ph.D., Head of Department of Urology St. Petersburg, Russia

S. Popov

St. Luke’s Clinical Hospital; St. Petersburg State University; S.M. Kirov Military Medical Academy

Email: doc.popov@gmail.com
Urologist at the Department of Urology; Dr.Med.Sci., Prof. at the Department of Urology St. Petersburg, Russia

A. Martov

Moscow City Clinical Hospital No. 57

Email: martovalex@mail.ru
Dr.Med.Sci., Prof., Head of Department of Urology; Head of Department of Urology Moscow, Russia

E. Gallyamov

A.I. Evdokimov Moscow State University of Medicine and Dentistry

Dr.Med.Sci., Prof. at the Department of Surgery Moscow, Russia

S. Malevich

St. Luke’s Clinical Hospital

Email: malevichsm@gmail.com
St. Petersburg, Russia

I. Sushina

St. Luke’s Clinical Hospital

Email: irasushina@yandex.ru
Urologist at the Department of Urology St. Petersburg, Russia

E. Grin’

St. Luke’s Clinical Hospital

Email: sv.lukaendouro@gmail.com
Urologist-andrologist at the Department of Urology St. Petersburg, Russia

A. Sanzharov

City Clinical Hospital No. 40

Urologist-andrologist at the Department of Urology Ekaterinburg, Russia

A. Novikov

Multidisciplinary Medical Center of the Bank of Russia

Head of Department of Urology Moscow, Russia

V. Sergeev

Moscow City Oncological Hospital No. 62

Email: ippofmbc@mail.ru
Head of Department of Urologic Oncology Moscow Region, Russia

A. Kochkin

Clinical Hospital at Gorky Railway Station of JSC «RZD»

Email: kochman@bk.ru
Ph.D., Urologist at the Department of Urology Nizhny Novgorod, Russia

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