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    Korean J Urol. 2008 May;49(5):418-423. Korean.
    Published online May 31, 2008.
    https://doi.org/10.4111/kju.2008.49.5.418
    Copyright © 2008 The Korean Urological Association
    Original Article

    Initial Experience of Laparoscopic Simple Prostatectomy in Patients with Large Benign Prostatic Hyperplasia

    Byung Hwan Kim, Dong Soo Ryu and Tae Hee Oh
      • Department of Urology, Sungkyunkwan University School of Medicine, Seoul, Korea.
    Received February 11, 2008; Accepted April 03, 2008.

    Abstract

    Purpose

    Simple prostatectomy has been a mainstay of therapy for patients with large prostatic adenoma. We describe laparoscopic approach for resection of large prostatic adenoma as an alternative to open simple prostatectomy.

    Materials and Methods

    From July 2006 to May 2007 we performed Laparoscopic simple prostatectomy on 10 patients who were diagnosed with clinically benign prostate hyperplasia (maximal urine flow rate (MFR) ≤10ml/sec, International Prostate Symptom Score (IPSS) ≥12 scores, and prostate weight ≥75g). The steps of our extraperitoneal 5 port technique were longitudinal cystotomy, subcapsular plane development, enucleation of the obstructing prostatic adenoma, insertion of Spongospan into the prostatic fossa, traction of 22Fr balloon catheter and suture repair of cystotomy.

    Results

    We successfully performed the operation in all cases without conversion. The mean patient age is 68.1 years old (60-73). The mean preoperative PSA, prostate volume were 8.8ng/ml (1.8-16.9), 97g (74.1-120.6). The mean operating time and estimated blood loss were 204min (160-275) and 720ml (300-1,200). The resected mass weight was 45.5g (23-70). There were no major complications. The mean hospitalization stay and drain remove days were 11.3 days (9-14) and 5.6 days (4-8). The mean preoperative MFR, IPSS/quality of life (QoL) and were 2.8ml/sec (0-9.6), 25/5 (14-35/4-6) and 270ml (250-310). At 3 months postoperatively, the mean MFR, IPSS/QoL and residual urine volume were 15.6ml/sec (12-23), 10/2.6 (5-12/2-4) and 16.75 (10-40).

    Conclusions

    Laparoscopic simple prostatectomy could be a useful method for the treatment of large benign prostate hyperplasia. However, more experiences and comparative studies are needed to document the safe and effect compared to open prostatectomy and transurethral resection of prostate.

    Keywords
    Prostatic hyperplasia; Prostatectomy; Adenoma; Laparoscopy

    Figures

    Fig. 1
    Circumferential mucosal incision of bladder neck.

    Fig. 2
    Enucleation of adenoma by laparoscopic dissection.

    Fig. 3
    Prostatic fossa after removal of the adenoma.

    Tables

    Table 1
    Patient characteristics and operative results

    Table 2
    Comparison of preoperative and postoperative Qmax, IPSS/QoL and PVR

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    MeSH Terms
    Adenoma
    Catheters
    Cystotomy
    Hospitalization
    Humans
    Hyperplasia
    Laparoscopy
    Prostate
    Prostatectomy
    Prostatic Hyperplasia
    Sutures
    Traction
    Metrics
    Share
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