Annotation. The MEDLINE/PubMed database was searched for all original articles published between 2011 and 2022 analyzing the incidence, prevalence, complications and surgical treatment of benign prostatic hyperplasia using laparoscopic prostatectomy (including retropubic interventions) and open retropubic prostatectomy to compare advantages and disadvantages of the both approaches. It was found that transperitoneal approach was used in 104 (12.4%) patients, extraperitoneal – 739 (87.6%). Complications of the I degree according to Clavien-Dindo inpatient period were observed in 4 (0.5%) patients; complications of the II degree – 10 (1.2%), complications of the IIIa degree – 5 (0.6%). Complications of the III, IV and V degrees were not identified, mortality was absent. Complications of the I degree according to Clavien-Dindo after discharge from the hospital (up to 90 days of observation) were discovered in 42 (5%) patients, complications of the II degree – in 13 (0.6%). Laparoscopic prostatectomies had a low percentage of intraoperative blood transfusions (1.2%), strictures of the urethra/bladder neck (0.35%) and fistula formation (0.12%). No wound infection was observed in any patient. Laparoscopic prostatectomies have the significant advantages over open prostatectomies, and therefore they should be more widely used in Ukraine.

Summary. Inguinal hernia is found in 2-8% of patients with benign prostatic hyperplasia. The possibility of simultaneous elimination of prostatic obstruction and inguinal hernia requires improvement of the method of hemostasis during the performance of recumbent prostatectomy in order to reduce blood loss and time of surgery is a pressing issue for both abdominal surgery and urology. Purpose of research. Improve the method of hemostasis in the performance of one-stage prostatectomy and simultaneous preabdominal plastic of inguinal hernia in patients with benign prostatic hyperplasia and inguinal hernia to reduce blood loss and time of operation. Materials and methods of research. Preabdominal plastic of the inguinal hernia during a single-stage concurrent prostatectomy was performed for 32 patients with benign prostatic hyperplasia. The first 6 patients, preperitoneal gernioplasty was performed before retropubic prostatectomy, for the last 26 patients - after a prostatectomy because of the possibility of loosening of the applied sutures at stretching of a wound by hooks. Research and discussion of results. In order to reduce bleeding during prostate prostatectomy and time of surgery, we proposed to perform hemostatic U-shaped catgut sutures (No. 6) on the lateral surfaces of the prostate capsule on muscle pieces (pads) of the pyramidal abdominal muscle. Intraoperative blood loss during surgery was determined by weight. The application of the hemostasis technique in the performance of a single-stage concurrent prostatectomy and simultaneous preperitoneal plasticity of inguinal hernias for patients with benign prostatic hyperplasia and inguinal hernia allowed to reduce the duration of surgery by 10-15 minutes, and blood loss by 150-250 ml. Conclusions. The results of improvement of the method of hemostasis in the performance of a single-stage concurrent prostatectomy and simultaneous preperitoneal hernioplasty in patients with benign prostatic hyperplasia and inguinal hernia show a decrease in the duration of surgery and intraoperative blood loss. The use of mesh prosthesis in the performance of pre-abdominal plastics of inguinal hernias and one-time supraventricular prostatectomy allows one surgical pathology to be eliminated simultaneously with one access, to prevent recurrence of hernia, to improve the quality of life of the patient and to have economic justification.

Annotation. The aim of the study was to evaluate the immediate and long-term results of valvular prostatectomy and simultaneous peritoneal hernioplasty in patients with benign prostatic hyperplasia and inguinal hernia and assess the quality of life of patients. The article presents the treatment results of 152 patients with benign prostatic hyperplasia. All individuals were divided into two groups. The general group consisted of 32 (21.1%) patients with benign prostatic hyperplasia and inguinal hernia, who underwent one-stage retropubic prostatectomy and simultaneous preperitoneal hernia repair. The comparison group consisted of 120 (78.9%) patients with benign prostatic hyperplasia who underwent only a one-stage retropubic prostatectomy. Assessment of the life quality of patients after simultaneous preperitoneal inguinal hernia repair was performed according to the EuraHS - Quality of Life scale in 6 and 12 months after surgery. The obtained quantitative data were processed by the variation statistic methods with the calculation of t-Student criteria. The data were considered reliable at a significance level of 0.95 (p<0.05). The average age of men in the comparison group was 68.0±7.2 years, in the general group – 67.1±6.9 years; the average prostate volume in the comparison group was 94.4±42.3 cm3, in the general group – 91.2±32.6 cm3; 44 (36.7%) patients of the comparison group and 4 (12.5%) patients of the general group were admitted to the department urgently (due to acute urinary retention or chronic complete urinary retention). The inguinal hernia was found in all 32 patients of the general group, among them in 4 men – on both sides. The average time of ciliary prostatectomy in the general group and in the comparison group was the same (82.8±25.6 and 80.1±17.4 minutes). The simultaneous inguinal hernia repair on the one side lasted 55.0±17.4 minutes. Neurological complications in the general group were noted in 2 (6.25%) patients, in the comparison group – in 9 (7.5%); urological complications took place in 11 (34.2%) and 40 (33.3%), respectively. The average postoperative inpatient stay in the general group was 9.5±1.7; in the comparison group – 9.8±2.9. It was statistically better due to these periods after surgery when compared with preoperative life quality.

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The objective: to estimate methods of haemostasis and restore of bladder-urethral segment during retropubic prostatectomy in patients with benign prostatic hyperplasia. Materials and methods. Analysis of methods of haemostasis and restore of bladder-urethral segment during retropubic prostatectomy in patients with benign prostatic hyperplasia was performed. Results. Open retropubic prostatectomy (like transbladder prostatectomy) was recommended by European Association of Urology (EAU, 2020) as operation of first choice for surgical treatment big size prostatic hyperplasias. The authors gave such prevalences of retropubic prostatectomy over trans-bladder: operation is performed under visual control that gives haemostatic control of prostatic cavity and removing all parts of nodules; the bladder is not drainaged that avoids disuria in postoperative period, decreases postoperative bed-time and increases comfort for patients; urethra is cut by scissor in apical part of prostate that is prophylaxis tearing of urethra, trauma of exernal sphincter, stricture of memranaceas urethra and urine incontinence after operation; reconstruction of bladder-urethral segment is performed that is prophylaxis of stricture of bladder neck; surgeon can performed simultaneous hernioplasty and retropubic prostatectomy in case of inquinal hernia and benign prostatic hyperplasia. Arterial and venous blood supplying of bladder and enlarged prostate were wrote. Places of arterial and venous bleeding after cutting of prostatic capsule and removing nodules, prophylaxis suturing of arterial and venous bleeding places were noted. Original own methods of restoring of bladder-urethral segment and haemostasis of prostatic cavity by using two or three П-like catgut sutures were shown. For simplifying operation and decreasing time of performing operation and increasing haemostasis of prostatic cavity authors recommended performing passing haemostatic sutures throught prostatic capsule only once and linking of sutures on muscle peaces from rectus muscle (or pyramidal muscle). In case of absent bleeding from prostatic cavity the simplify method of bladder neck trigonisation by using two П-like catgut sutures or two V-like catgut sutures on bladder neck for prophylaxis of bladder neck stenosis was recommended (proximal trigonisation of bladder neck in prostatic cavity). Review of haemostatic merhods of prostatic cavity during retropubic prostatectomy was shown. Conclusion. Analysis of methods of haemostasis and restore of bladder-urethral segment and own original methods during retropubic prostatectomy in patients with benign prostatic hyperplasia allow improve haemostasis of prostatic cavity, prophylaxis of bladder neck and urethra stenosis, decrease intraoperative bleeding and period of operation.