Diagnosis and Conservative Management of Ureteral Orifice Injury During Robotic Prostatectomy for a Large Prostate with a Prominent Median Lobe

Background. The increased volume of the prostate in patients with confirmed prostate cancer (pc) is observed in 10 % of cases. The limitations of external beam radiotherapy and brachytherapy associated with large prostate volume and obstructive symptoms define radical prostatectomy (Rp) as the only possible treatment for prostate cancer in these patients. The purpose of the study was to determine the importance of the surgical approach in radical prostatectomy in patients with abnormal anatomy of the prostate. Material and methods. The study group consisted of patients with a prostate volume of more than 80 cm3 (n=40) who underwent a robot prostatectomy. The comparison group was represented by patients also selected by the prostate volume ≥ 80 cm3, who underwent classical open prostatectomy (n=44). The groups were comparable in age and psa level. The average prostate volume in the study group was 112.2 ± 26 cm 3(80–195 cm 3). The average prostate volume in the comparison group was 109.8 ± 18.7 cm3 (80–158 cm 3) (р>0.05). Both groups had favorable morphological characteristics. Results. The average surgery time difference was 65 minutes in favor of the open prostatectomy (p<0.05). The average blood loss volume in the study group was 282.5 ± 227.5 ml (50–1000 ml). The average blood loss volume in the group with open prostatectomy was 505.7 ± 382.3 ml (50–2000 ml). Positive surgical margin in the robotic prostatectomy was not detected, at 6.9 % in the group with open prostatectomy (p<0.05). According to the criterion of urinary continence, the best results were obtained in the group of robotic prostatectomy (p<0.05). Overall and relapse-free 5-year survival did not show a statistically significant difference. Conclusion. The use of robotic prostatectomy in a group of patients with a large prostate volume (≥ 80 cm3) allows us to achieve better functional and oncological outcomes.

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Ejaculatory-sparing robot-assisted “Pure” adenomectomy for large prostate adenoma even with median lobe

European Urology Supplements ◽

10.1016/s1569-9056(19)32756-3 ◽

2019 ◽

Vol 18 (6) ◽

pp. e2647

Author(s):

F. Porpiglia ◽

E. Checcucci ◽

R.G. Niculescu ◽

D. Amparore ◽

S. De Cillis ◽

...

Keyword(s):

Median Lobe ◽

Robot Assisted ◽

Prostate Adenoma ◽

Large Prostate

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A 87 YEARS OLD MALE WITH GIANT PROSTATIC HYPERPLASIA AND BLADDER STONES, THE LARGEST PROSTATE REPORTED IN INDONESIA

Indonesian Journal of Urology ◽

10.32421/juri.v24i2.277 ◽

2017 ◽

Vol 24 (2) ◽

Author(s):

Vera Vera ◽

Sawkar Vijay Pramod

Keyword(s):

Body Mass Index ◽

Benign Prostate Hyperplasia ◽

Prostatic Hyperplasia ◽

Chief Complaint ◽

Median Lobe ◽

Prostate Hyperplasia ◽

Case Presentation ◽

Prostate Weight ◽

Large Prostate ◽

Benign Prostate

Objective: The aim of this article is to report a case of Giant Prostatic Hyperplasia and see the correlation between volume of prostate and benign prostate hyperplasia (BPH) symptoms. Giant BPH is defined as a prostate weight over 200 g or 500 g; the lower threshold was suggested by Japanese authors. It’s extremely rare, with only 16 cases exceeding 500 g till 2013. Case presentation: Patient was an 87-year-old male with chief complaint of haematuria. We performed Transabdominal Ultra Sonography (USG) on the patient. Discussion: Transabdominal USG showed enlarged prostate with median lobe protruding into the bladder measuring 86 x 102 x 76 mm and 348 cc in volume. We performed transvesical prostatectomy. The large prostate was enucleated completely in one piece with 23 stones measuring about 1 cm in size. Grossly, the mass measured 12 x 8 cm and weighed 300 g. Histopathology evaluation revealed BPH. Conclusion: To our knowledge, this is the first giant BPH case being reported in Indonesia. We would like to emphasize that severity of BPH symptoms does not correlate with volume of the prostate. Unfortunately, we can not conclude that there were correlation between body mass index (BMI) and volume due to lack of BMI data from the literature.

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