Minimally invasive simple prostatectomy in the era of laser enucleation for high-volume prostates: A systematic review and meta-analysis

Chebel, Josselin Abi; Sarkis, Julien; Helou, Elie El; Hanna, Elie; Tayeh, Georges Abi; Semaan, Albert

doi:10.1080/2090598x.2020.1789809

Cited by 10 publications

(5 citation statements)

References 22 publications

(37 reference statements)

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“…Meanwhile, US-LSP could reduce the risk of SUI in patients with a history of posterior urethral surgery. These results were in line with previous studies [ 4 , 9 , 13 ].…”

Section: Discussionsupporting

confidence: 94%

Urethral-sparing laparoscopic simple prostatectomy for the treatment of benign prostatic hyperplasia with asymptomatic urethral stricture after urethral stricture surgery

Hou,

Luo,

Cao

et al. 2024

BMC Urol

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Objective To evaluate the efficacy of urethral-sparing laparoscopic simple prostatectomy (US-LSP) for the treatment of large-volume (>80 ml) benign prostatic hyperplasia (BPH) with asymptomatic urethral stricture (urethral lumen > 16 Fr) after urethral stricture surgery. Methods We retrospectively analyzed clinical data of 39 large-volume BPH patients with asymptomatic urethral stricture after urethral stricture surgery who underwent US-LSP from January 2016 to October 2021. Postoperative follow-ups were scheduled at 1, 3, and 6 months. Results All patients affected by significant BPH-related lower urinary tract symptoms (LUTS) including 22 cases with asymptomatic anterior urethral stricture and 17 cases with asymptomatic posterior urethral stricture. Median operative time was 118 min (interquartile range [IQR]100–145). Median estimated blood loss was 224 ml (IQR: 190–255). 33 patients(84.6%) avoided continuous bladder irrigation. Postoperative complications occurred in 5 patients (12.8%), including 4 cases with Clavien-Dindo grade 1 and grade 2 and 1 case with grade 3a. During follow-up, US-LSP presented statistically significant improvements in LUTS compared to baseline (P < 0.05). A total of 25 patients had normal ejaculation preoperatively and 3 patients (12%) complained retrograde ejaculation postoperatively. Two patients (5.1%) reported stress urinary incontinence (SUI) and no patient reported aggravated urethral stricture during follow-up. Conclusions US-LSP was safe and effective in treating large-volume BPH with asymptomatic urethral stricture after urethral stricture surgery. Meanwhile, US-LSP could reduce the risk of SUI in patients with asymptomatic posterior urethral stricture and maintain ejaculatory function in a high percentage of patients.

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“…Meanwhile, US-LSP could reduce the risk of SUI in patients with a history of posterior urethral surgery. These results were in line with previous studies [ 4 , 9 , 13 ].…”

Section: Discussionsupporting

confidence: 94%

Urethral-sparing laparoscopic simple prostatectomy for the treatment of benign prostatic hyperplasia with asymptomatic urethral stricture after urethral stricture surgery

Hou,

Luo,

Cao

et al. 2024

BMC Urol

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“…Для зменшення та уникнення зазначених вище ускладнень і наслідків відкритих простатектомій у практику урологів у 2002 р. впроваджено лапароскопічну простатектомію [4][5][6][7], а у 2008 р. -лапароскопічну робот-асистовану простатектомію [8][9][10][11][12][13][14][15]. Ці операції об'єднують одним терміном -«мінімально інвазивні простатектомії».…”

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Laparoscopic Prostatectomy in Surgical Treatment of Benign Prostatic Hyperplasia

Moraru-Burlesku,

Shaprynskyi,

Gorovyi

et al. 2023

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In a contrast to the trauma of open prostatectomy, an alternative treatment for benign prostatic hyperplasia (BPH) is laparoscopic prostatectomy. It was implemented in the practical work of urologists as a minimally invasive alternative procedure to open prostatectomies (transvesical and pubic) in patients with large BPH. The objective: to consider technique and analysis of the results of laparoscopic extraperitoneal pubic (transcapsular) prostatectomy in patients with large BPH (more than 80 ml). Materials and methods. The early (inpatient) and long-term (after discharge from the hospital and up to two years of followup) results of laparoscopic extraperitoneal pubic (transcapsular) prostatectomy in 50 patients with BPH who were operated in Center for Plastic Reconstructive and Minimally Invasive Oncourology of the Cherkasy Regional Oncology Dispensary and the Urology Department of the Vinnytsia Regional Clinical Hospital named after M. I. Pirogov during 2021–2023 are presented. The average age of the patients was 68.2±2.4 years old, the average body mass index was 28.5±1.5, and the average volume of the prostate gland (PG) was 111.5±17.4 ml. Laparoscopic extraperitoneal pubic prostatectomy was performed by creating a pre-abdominal pubic space using a Space Marker balloon trocar. The incision of the PG capsule is transverse, hyperplastic parts of the bladder were removed with step-by-step hemostasis with an attempt to preserve the wall of the prostatic urethra, the anastomosis between the bladder neck and the bladder capsule was placed using a continuous V-Loc suture (2-0). Hyperplastic nodes of the PG were removed by morcellation. The urethral catheter was removed on the 5th day after surgery. The quality of urination before and after surgery was assessed using the International Symptom Questionnaire for PG diseases before and after surgery. Results. The average operation time was 120.3±11.7 min, the average intraoperative blood loss was 118.7±33.6 ml. In 10 (20%) patients the prostatic part of the ureter was saved. One patient had a stone removed from the urinary bladder by cystotomy, another patient had simultaneous pre-abdominal laparoscopic inguinal hernioplasty with a mesh polypropylene implant for an oblique hernia. No intraoperative or postoperative bleeding was observed, no hemotransfusion was performed. The average postoperative bed-day was 6.1±1.1 days. In the postoperative period (up to two years), complications (ureteral and bladder neck strictures, bladder stones, urinary incontinence, infectious complications, etc.) were not registered. Conclusions. The obtained results of laparoscopic extraperitoneal pubic prostatectomy in patients with large BPH confirmed its reliable intra- and postoperative hemostasis, short postoperative bed-day, satisfactory recovery of the act of urination with a minimum number of complications. Further studies should be conducted to establish the benefits of performing laparoscopic extraperitoneal pubic prostatectomy in patients with BPH.

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“…Однако следует отметить, что в двух исследованиях сообщалось о более выраженной послеоперационной дизурии и недержании мочи в группе лазерной энуклеации. Данный систематический обзор литературы и метаанализ продемонстрировали безопасность и эффективность как лазерной энуклеации, так и лапароскопической аденомэктомии в лечении ДГПЖ больших размеров [19].…”

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Laparoscopic Simple Prostatectomy in Treatment of Benign Prostatic Hyperplasia of High Risk of Progression

Милошевский¹

2021

Хирургия. Восточная Европа

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Доброкачественная гиперплазия предстательной железы (ДГПЖ) является одним из распространенных заболеваний мочевыводящих путей у мужчин, снижающим качество жизни. Такие факторы, как тяжесть симптомов мочеиспускания, определяемая с помощью международной шкалы оценки простатических симптомов в баллах (IPSS), снижение максимальной скорости мочеиспускания (Qmax), увеличенный объем предстательной железы, объем остаточной мочи и высокий уровень простатспецифического антигена (ПСА), способствуют прогрессии ДГПЖ и влияют на выбор метода лечения. В последние годы метаболический синдром, инсулинорезистентность со вторичной гиперинсулинемией, сахарный диабет, гормональные изменения, воспаление и внутрипузырная протрузия предстательной железы выделены как дополнительные факторы прогрессии ДГПЖ. Лапароскопическая аденомэктомия в лечении ДГПЖ высокого риска прогрессии (более 80 см3) является безопасным и эффективным малоинвазивным методом, обеспечивая аналогичные функциональные результаты с открытой аденомэктомией и имея значительные преимущества в таких показателях, как предполагаемая кровопотеря, время стояния уретрального катетера, время нахождения в стационаре, частота гемотрансфузии и частота осложнений. Benign prostatic hyperplasia (BPH) is one of the most common diseases of the urinary tract in men, which reduces the quality of life. Such factors as the severity of urinary symptoms, as measured by the International Prostate Symptom Score (IPSS), decreased maximum urinary flow rate (Qmax), enlarged prostate volume, residual urine volume, and high prostate-specific antigen (PSA) level contribute to the progression of BPH and influence the choice of treatment method. In recent years, metabolic syndrome, insulin resistance with secondary hyperinsulinemia, diabetes mellitus, hormonal changes, inflammation, and intravesical protrusion of the prostate have been identified as additional factors in the progression of BPH. Laparoscopic simple prostatectomy is a safe and effective minimally invasive method in the treatment of BPH of high risk of progression (over 80 cm3), providing similar functional results with open adenomectomy and having significant advantages in such indicators as estimated blood loss, catheterization time, length of hospital stay, transfusion rate, frequency of complications.

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Minimally invasive simple prostatectomy in the era of laser enucleation for high-volume prostates: A systematic review and meta-analysis

Cited by 10 publications

References 22 publications

Urethral-sparing laparoscopic simple prostatectomy for the treatment of benign prostatic hyperplasia with asymptomatic urethral stricture after urethral stricture surgery

Urethral-sparing laparoscopic simple prostatectomy for the treatment of benign prostatic hyperplasia with asymptomatic urethral stricture after urethral stricture surgery

Laparoscopic Prostatectomy in Surgical Treatment of Benign Prostatic Hyperplasia

Laparoscopic Simple Prostatectomy in Treatment of Benign Prostatic Hyperplasia of High Risk of Progression

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