Laparoscopic retropubic extraurethral adenomectomy
Introduction. Existing methods of surgical treatment of benign prostatic hyperplasia are accompanied by the frequent development of postoperative complications, such as urinary incontinence, retrograde ejaculation, and urethral strictures. The method of preserving the prostatic urethra has been deve...
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| Format: | Article |
| Language: | Russian |
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Ministry of Health of Russian Federation, Rostov State Medical University, State Budget Educational Institute of Higher Professional Education
2022-06-01
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| Series: | Вестник урологии |
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| Online Access: | https://www.urovest.ru/jour/article/view/545 |
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| author | S. N. Eremenko A. N. Eremenko V. Yu. Mykhaylichenko V. P. Dolgopolov V. S. Chernega A. S.-A. Khalilova |
| author_facet | S. N. Eremenko A. N. Eremenko V. Yu. Mykhaylichenko V. P. Dolgopolov V. S. Chernega A. S.-A. Khalilova |
| author_sort | S. N. Eremenko |
| collection | DOAJ |
| description | Introduction. Existing methods of surgical treatment of benign prostatic hyperplasia are accompanied by the frequent development of postoperative complications, such as urinary incontinence, retrograde ejaculation, and urethral strictures. The method of preserving the prostatic urethra has been developed for a long time. At present, it is possible to use the operation technique and perform laparoscopic urethral-sparing adenomectomy.Objective. To assess the possibility of performing extraurethral adenomectomy with prostatic urethral preservation using the laparoscopic approach, its advantages and disadvantages.Materials and methods. Based on St. Luke’s Simferopol сlinical Multidisciplinary Medical Center, 35 successful laparoscopic operations were performed to remove benign prostate hyperplasia with the prostatic urethra preservation. The features of the operation are laparoscopic access, a transverse section of the capsule, alternate isolation of adenomatous nodes while preserving the prostatic urethra on the catheter without replacing it during the operation, suturing the capsule with a decrease in space from the removed adenomatous nodes. Urethral preservation provided accelerated epithelialization of the defect, in the absence of the formation of a “prevesical” space.Results. After the operation, it is possible to turn off the urinary bladder irrigation system earlier (up to 4 – 6 hours after the operation) and early removal of the catheter after surgery (2 – 3 days). The hospital stay averaged 5.7 days. Urination was restored immediately after catheter removal in 92% of the patients. There were no elements of dysuria, particularly urinary incontinence. Prostate volume measured throughout transrectal ultrasound after operation was 20 – 24 cm³.Conclusion. The technique of retropubic extraurethral adenomectomy with prostatic urethral preservation can be performed in laparoscopic technique. The advantages are early activation of the patient and discharge from the hospital, early removal of the catheter with restoration of independent urination, absence of dysuria, urinary incontinence, and postoperative complications. The results of our study demonstrate the effectiveness of the laparoscopic extraurethral adenomectomy technique, the further development of this technique, and the possibility of its application in practice. |
| format | Article |
| id | doaj-art-772be8754e0542019ac334197dbcf521 |
| institution | Kabale University |
| issn | 2308-6424 |
| language | Russian |
| publishDate | 2022-06-01 |
| publisher | Ministry of Health of Russian Federation, Rostov State Medical University, State Budget Educational Institute of Higher Professional Education |
| record_format | Article |
| series | Вестник урологии |
| spelling | doaj-art-772be8754e0542019ac334197dbcf5212025-08-20T03:43:33ZrusMinistry of Health of Russian Federation, Rostov State Medical University, State Budget Educational Institute of Higher Professional EducationВестник урологии2308-64242022-06-01102435210.21886/2308-6424-2022-10-2-43-52371Laparoscopic retropubic extraurethral adenomectomyS. N. Eremenko0A. N. Eremenko1V. Yu. Mykhaylichenko2V. P. Dolgopolov3V. S. Chernega4A. S.-A. Khalilova5V.I. Vernadsky Crimean Federal UniversityV.I. Vernadsky Crimean Federal UniversityV.I. Vernadsky Crimean Federal UniversityV.I. Vernadsky Crimean Federal UniversitySevastopol State UniversityV.I. Vernadsky Crimean Federal UniversityIntroduction. Existing methods of surgical treatment of benign prostatic hyperplasia are accompanied by the frequent development of postoperative complications, such as urinary incontinence, retrograde ejaculation, and urethral strictures. The method of preserving the prostatic urethra has been developed for a long time. At present, it is possible to use the operation technique and perform laparoscopic urethral-sparing adenomectomy.Objective. To assess the possibility of performing extraurethral adenomectomy with prostatic urethral preservation using the laparoscopic approach, its advantages and disadvantages.Materials and methods. Based on St. Luke’s Simferopol сlinical Multidisciplinary Medical Center, 35 successful laparoscopic operations were performed to remove benign prostate hyperplasia with the prostatic urethra preservation. The features of the operation are laparoscopic access, a transverse section of the capsule, alternate isolation of adenomatous nodes while preserving the prostatic urethra on the catheter without replacing it during the operation, suturing the capsule with a decrease in space from the removed adenomatous nodes. Urethral preservation provided accelerated epithelialization of the defect, in the absence of the formation of a “prevesical” space.Results. After the operation, it is possible to turn off the urinary bladder irrigation system earlier (up to 4 – 6 hours after the operation) and early removal of the catheter after surgery (2 – 3 days). The hospital stay averaged 5.7 days. Urination was restored immediately after catheter removal in 92% of the patients. There were no elements of dysuria, particularly urinary incontinence. Prostate volume measured throughout transrectal ultrasound after operation was 20 – 24 cm³.Conclusion. The technique of retropubic extraurethral adenomectomy with prostatic urethral preservation can be performed in laparoscopic technique. The advantages are early activation of the patient and discharge from the hospital, early removal of the catheter with restoration of independent urination, absence of dysuria, urinary incontinence, and postoperative complications. The results of our study demonstrate the effectiveness of the laparoscopic extraurethral adenomectomy technique, the further development of this technique, and the possibility of its application in practice.https://www.urovest.ru/jour/article/view/545laparoscopybenign prostatic hyperplasiaextraurethral adenomectomyprostatic urethraprevesical |
| spellingShingle | S. N. Eremenko A. N. Eremenko V. Yu. Mykhaylichenko V. P. Dolgopolov V. S. Chernega A. S.-A. Khalilova Laparoscopic retropubic extraurethral adenomectomy Вестник урологии laparoscopy benign prostatic hyperplasia extraurethral adenomectomy prostatic urethra prevesical |
| title | Laparoscopic retropubic extraurethral adenomectomy |
| title_full | Laparoscopic retropubic extraurethral adenomectomy |
| title_fullStr | Laparoscopic retropubic extraurethral adenomectomy |
| title_full_unstemmed | Laparoscopic retropubic extraurethral adenomectomy |
| title_short | Laparoscopic retropubic extraurethral adenomectomy |
| title_sort | laparoscopic retropubic extraurethral adenomectomy |
| topic | laparoscopy benign prostatic hyperplasia extraurethral adenomectomy prostatic urethra prevesical |
| url | https://www.urovest.ru/jour/article/view/545 |
| work_keys_str_mv | AT sneremenko laparoscopicretropubicextraurethraladenomectomy AT aneremenko laparoscopicretropubicextraurethraladenomectomy AT vyumykhaylichenko laparoscopicretropubicextraurethraladenomectomy AT vpdolgopolov laparoscopicretropubicextraurethraladenomectomy AT vschernega laparoscopicretropubicextraurethraladenomectomy AT asakhalilova laparoscopicretropubicextraurethraladenomectomy |