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• W2053016855 abstract "No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Jul 2001A PROSPECTIVE STUDY OF THE SAFETY AND EFFICACY OF SUPRAPUBIC TRANSVESICAL PROSTATECTOMY IN PATIENTS WITH BENIGN PROSTATIC HYPERPLASIA ANDREA TUBARO, SIMON CARTER, AHMAD HIND, CARLO VICENTINI, and LUCIO MIANO ANDREA TUBAROANDREA TUBARO More articles by this author , SIMON CARTERSIMON CARTER More articles by this author , AHMAD HINDAHMAD HIND More articles by this author , CARLO VICENTINICARLO VICENTINI More articles by this author , and LUCIO MIANOLUCIO MIANO More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)66102-2AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We investigate the safety and efficacy of suprapubic transvesical prostatectomy, and the change in bladder wall thickness after surgery. Materials and Methods: We conducted a prospective 1 center study of 32 consecutive patients who underwent transvesical prostatectomy from December 1996 to March 1997 for benign prostatic hyperplasia with large prostate volume, who were followed for 1 year. Pressure flow study and transrectal sonography were performed at baseline and repeated at 6 months. Bladder wall thickness was measured at baseline and regular intervals postoperatively. A morbidity questionnaire was completed during the first 6 weeks after surgery. Results: An average of 63 gm. prostate adenoma were enucleated at surgery. An indwelling catheter was required for an average plus or minus standard deviation of 5.4 ± 2.6 days after treatment. The International Prostate Symptom Score decreased from 19.9 ± 4.4 to 1.5 ± 2.7 and the quality of life score decreased from 4.9 ± 1.0 to 0.2 ± 0.4 at year 1, respectively. Maximum flow rate improved from 9.1 ± 5.3 to 29.0 ± 8.9 ml. per second. Residual urine decreased from 128 ± 113 to 8 ± 18 ml. Before surgery 30 patients had obstruction and 2 were in the equivocal zone of the International Continence Society nomogram. At 6 months after prostatectomy 30 patients did not have obstruction, and 2 who were subsequently operated on for bladder neck sclerosis were equivocal and had obstruction, respectively. No patient had significant postoperative bleeding and no heterologous blood transfusions were required. There were 4 men who had urinary tract infection and 1 who had wound infection. A slight decrease in erectile function was observed 6 weeks postoperatively, and no change in patient libido and quality of sex life was reported. The total complication rate was 31.3%. The bladder was unstable in 7 men before and 3 after surgery. A significant decrease in bladder wall thickness was observed from 5.2 ± 0.7 at baseline to 2.9 ± 0.9 mm. at year 1 postoperatively. Conclusions: Our study confirms the excellent clinical outcome of transvesical prostatectomy, and rapid improvement of most subjective and objective parameters during the 4 weeks after surgery. Bladder hypertrophy appears to be significantly reduced after prostate surgery. The urodynamic results in patients who underwent open surgery probably represent the maximum obtainable relief of obstruction and should be considered the reference standard to which all other treatments, including transurethral resection, should aspire. References 1 : Is open prostatectomy really obsolete?. Urology1992; 40: 419. Google Scholar 2 : Combined retropubic prostatectomy and preperitoneal inguinal herniorrhaphy. J Urol1988; 140: 1442. Link, Google Scholar 3 : One thousand cases of total enucleation of the prostate for radical cure of enlargement of that organ. Br Med J1912; 2: 868. Google Scholar 4 : Retropubic Urinary Surgery. Edinburgh: E & S Livingstone1947. 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Link, Google Scholar 19 : Open prostatectomy. In: Benign Prostatic Hyperplasia: Current Therapy. Edited by . London: Martin Duniz Ltd.2000: 75. chapt. 5. Google Scholar 20 : The correlation between clinical outcome and residual prostatic weight ratio after transurethral resection of the prostate for benign prostatic hyperplasia. BJU Int2000; 85: 79. Google Scholar 21 : Urodynamic effects of various treatment modalities for benign prostatic hyperplasia. J Urol1997; 158: 2034. Link, Google Scholar 22 : Changes in the sexual behavior of couples after prostatectomy. A prospective study. Eur Urol1987; 13: 35. Google Scholar 23 : Holmium laser versus transurethral resection of the prostate: a randomized prospective trial with 1-year followup. J Urol1999; 162: 1640. Link, Google Scholar From the Division of Urology, Department of Surgical Sciences, L’Aquila University School of Medicine, L’Aquila, Italy, and Department of Urology, Hammersmith Hospitals Trust and Imperial College School of Medicine, London, United Kingdom© 2001 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byKaplan S (2015) Re: Improvement of Lower Urinary Tract Symptoms and Sexual Activity after Open Simple Prostatectomy: Prospective Analysis of 50 CasesJournal of Urology, VOL. 195, NO. 3, (690-691), Online publication date: 1-Mar-2016.Ajay D, Zhang H, Gupta S, Selph J, Belsante M, Lentz A, Webster G and Peterson A (2015) The Artificial Urinary Sphincter is Superior to a Secondary Transobturator Male Sling in Cases of a Primary Sling FailureJournal of Urology, VOL. 194, NO. 4, (1038-1042), Online publication date: 1-Oct-2015.Gratzke C, Schlenker B, Seitz M, Karl A, Hermanek P, Lack N, Stief C and Reich O (2018) Complications and Early Postoperative Outcome After Open Prostatectomy in Patients With Benign Prostatic Enlargement: Results of a Prospective Multicenter StudyJournal of Urology, VOL. 177, NO. 4, (1419-1422), Online publication date: 1-Apr-2007.MUZZONIGRO G, MILANESE G, MINARDI D, YEHIA M, GALOSI A and DELLABELLA M (2018) SAFETY AND EFFICACY OF TRANSURETHRAL RESECTION OF PROSTATE GLANDS UP TO 150 ML: A PROSPECTIVE COMPARATIVE STUDY WITH 1 YEAR OF FOLLOWUPJournal of Urology, VOL. 172, NO. 2, (611-615), Online publication date: 1-Aug-2004. Volume 166Issue 1July 2001Page: 172-176 Advertisement Copyright & Permissions© 2001 by American Urological Association, Inc.Keywordsurodynamicsprostatic hyperplasiasigns and symptomsprostatectomyMetricsAuthor Information ANDREA TUBARO More articles by this author SIMON CARTER More articles by this author AHMAD HIND More articles by this author CARLO VICENTINI More articles by this author LUCIO MIANO More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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