Comparison of immediate (inpatient) and long-term results of open and laparoscopic retropubic prostatectomies in surgical treatment of benign prostatic hyperplasia

Abstract

Annotation. The purpose of the study is to compare and evaluate the immediate (inpatient) and long-term results of open and laparoscopic retropubic prostatectomy in the surgical treatment of large benign prostatic hyperplasia (more than 80 ml). The immediate (inpatient) and long-term (after discharge from the hospital and up to 2 years of follow-up) results of one-time laparoscopic extraperitoneal retropubic prostatectomy in 50 patients with benign prostatic hyperplasia who were operated in the Clinical Center of Oncology, Hematology, Transplantology and Palliative Care of the Cherkasy Regional Council and urological department of the Vinnytsia Regional Hospital named after M. Pirogov in the period from 2021 to 2023, as well as 120 one-time open retropubic prostatectomies in patients with benign prostatic hyperplasia who were operated in the urological department of the Vinnytsia Regional Hospital named after M. Pirogov for the same period of time. The average time of laparoscopic prostatectomy was 120.3±11.7 minutes, open – 81.1±17.4; average intraoperative blood loss – 118.7±33.6 ml and 520.5±67.4 ml, postoperative bed-day 6.1±1.1 and 9.8±2.9, respectively. Transfusion of blood components due to blood loss was performed in 9 (7.5%) patients after open retropubic prostatectomy, never after laparoscopic. Urological complications after laparoscopic prostatectomy were noted in 2% of patients, open - 19.2%, complications according to Clavien-Dindo – 4% and 33.3%, respectively. According to the conducted uroflowmetry, it was noted that laparoscopic and open retropubic prostatectomies allow equally effective restoration of urination in patients after surgery. When analyzing the long-term results of treatment of patients with benign prostatic hyperplasia, fewer (2.5% versus 8%) postoperative complications were noted after laparoscopic pubic prostatectomy.