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Comparative study of extraperitoneoscopic adenomectomy and monopolar transurethral resection in surgical management of benign prostatic hyperplasia with prostate volume of 100–180 cm3
DOI: https://dx.doi.org/10.18565/urology.2018.2.88-91
R.G. Biktimirov, A.G. Martov, T.R. Biktimirov, D.I. Marapov, A.A. Kaputovskij
Federal Clinical Center for High Medical Technologies, FMBA of Russia, Moscow region, Khimki, Russia; Department of Urology and Andrology, A.I. Burnazyan SSC FMBC, FMBA of Russia, Moscow, Russia; Department of Public Health and Health Care Organization, Kazan State Medical University of Minzdrav of Russia, Kazan, Russia
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.
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.
About the Autors
Corresponding author: Kaputovskij A.A. – Urologist at the Federal Clinical Center for High Medical Technologies, Federal Biomedical Agency of Russia, Moscow, Russia; e-mail: kaputovsky79@mail.ru
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