Effects of open prostatectomy on uroflowmetry parameters on patients having benign prostatic hyperplasia

Several therapeutic approaches such as holmium laser enucleation of the prostate (HoLEP) have been introduced to relieve bladder outlet obstruction caused by benign prostatic hyperplasia (BPH). Compared with other techniques including the transurethral resection of the prostate (TURP) and simple open prostatectomy, HoLEP results in a shorter hospital stay and catheterization time and fewer blood loss and transfusions. HoLEP is a size-independent treatment option for BPH with average gland size from 36 g to 170 g. HoLEP is a safe procedure in patients receiving an anticoagulant and has no significant influence on the hemoglobin level. Also, HoLEP is an easy and safe technique in patients with a prior history of prostate surgery and a need for retreatment because of adenoma regrowth. The postoperative erectile dysfunction rate of patients treated with HoLEP is similar to TURP or open prostatectomy and about 77% of these patients experience loss of ejaculation. Patients with transitional zone volume less than 30 mL may suffer from persistent stress urinary incontinence following HoLEP so other surgical techniques like bipolar TURP are a good choice for these patients. In young patients, considering HoLEP with high prostate-specific antigen density and a negative standard template prostate biopsy, multiparametric MRI needs to be considered to exclude prostate cancer.

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Ten-Year Experience with Open Prostatectomy in Maiduguri

ISRN Urology ◽

10.5402/2012/406872 ◽

2012 ◽

Vol 2012 ◽

pp. 1-4 ◽

Cited By ~ 4

Author(s):

Ibrahim Ahmed Gadam ◽

Ali Nuhu ◽

Suleiman Aliyu

Keyword(s):

Urinary Tract ◽

Benign Prostatic Hyperplasia ◽

Lower Urinary Tract ◽

Clinical Laboratory ◽

Urinary Tract Obstruction ◽

Prostatic Hyperplasia ◽

Open Prostatectomy ◽

Elderly Male ◽

Lower Urinary Tract Obstruction ◽

Lower Urinary

Background. Benign prostatic hyperplasia is the most common cause of lower urinary tract obstruction in the elderly male. Aim. To evaluate the effectiveness, safety, and outcome of open prostatectomy in a Nigerian teaching hospital. Material and Methods. Two hundred and fifty-three men with lower urinary tract obstruction clinically due to benign prostatic hyperplasia (BPH) underwent open prostatectomy over a ten-year period (January 2001–December 2010). Data on patients including age, clinical, laboratory, and histology were reviewed and analyzed to determine treatment outcome. Results. A total of 253 patients were studied. Their mean age was 69.11 ± 10.9 years (range 50–98). The most common symptoms at presentation included frequency 229 (90.5%) and poor stream 225 (88.9%). The most common complications at presentation were stones in 41 (16.2%) and bleeding in 37 (14.6%). The most common comorbid conditions were hypertension and diabetes found in 72 (28.5%) and 23 (9.1%), respectively. Transvesical prostatectomy was done for most of the patients, 126 (49.8%). Clot retention and wound infection were the commonest postoperative complications accounting for 19 (7.5%) each. Transient incontinence occurred in 17 (6.7%) patients. There was 1 (0.4%) mortality. Conclusion. Open prostatectomy still has a prime place in the operative treatment of BPH with acceptable postoperative morbidity and very low mortality in the developing world with no facilities for TURP.

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Plasmakinetic Enucleation of the Prostate Versus Transvesical Open Prostatectomy for Benign Prostatic Hyperplasia >80 mL: 12-Month Follow-up Results of a Randomized Clinical Trial

Urology ◽

10.1016/j.urology.2013.02.032 ◽

2013 ◽

Vol 82 (1) ◽

pp. 176-181 ◽

Cited By ~ 38

Author(s):

Jian-Ming Rao ◽

Jin-Rui Yang ◽

Yi-Xin Ren ◽

Jiang He ◽

Ping Ding ◽

...

Keyword(s):

Clinical Trial ◽

Benign Prostatic Hyperplasia ◽

Randomized Clinical Trial ◽

Prostatic Hyperplasia ◽

Open Prostatectomy

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Perioperative evidence-based parallel in high volume benign prostatic hyperplasia cases – bipolar plasma enucleation versus standard open prostatectomy

European Urology Supplements ◽

10.1016/s1569-9056(15)30247-5 ◽

2015 ◽

Vol 14 (6) ◽

pp. e1211

Author(s):

C. Bulai ◽

P. Geavlete ◽

C. Moldoveanu ◽

M. Jecu ◽

F. Stanescu ◽

...

Keyword(s):

Benign Prostatic Hyperplasia ◽

High Volume ◽

Prostatic Hyperplasia ◽

Evidence Based ◽

Open Prostatectomy

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Benign prostatic hyperplasia with PSA > 10.0 ng/ml: Correlations between PSA density and pathological findings of the surgical specimen after open prostatectomy

Urologia Journal ◽

10.1177/039156039506201s01 ◽

1995 ◽

Vol 62 (1_suppl) ◽

pp. 7-10

Author(s):

V. Scattoni ◽

L. Ambrosiani ◽

P. Rovellini ◽

G. Toia ◽

S. Bellone ◽

...

Keyword(s):

Benign Prostatic Hyperplasia ◽

Urinary Infection ◽

Transrectal Ultrasound ◽

Prostatic Hyperplasia ◽

Pathological Findings ◽

Open Prostatectomy ◽

Indwelling Catheter ◽

Surgical Specimen ◽

Psa Density ◽

Density Values

— Thirty patients with benign prostatic hyperplasia and PSA levels > 10.0 ng/ml were submitted to open prostatectomy after a precise evaluation with transrectal ultrasound and prostatic biopsies. In the surgical specimen 7 prostatic carcinoma (23%) were found incidentally. In the remaining 23 patients the presence of active histological prostatitis was correlated with the PSA and PSA density values but was not directly due to an asymptomatic urinary infection or indwelling catheter. PIN and other pathological findings were not found to be correlated with PSA values.

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PP69 Prostatic Artery Embolisation For Benign Prostatic Hyperplasia

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462318002271 ◽

2018 ◽

Vol 34 (S1) ◽

pp. 94-94

Author(s):

Keng Ho Pwee

Keyword(s):

Benign Prostatic Hyperplasia ◽

Adverse Effects ◽

Adverse Events ◽

Systematic Reviews ◽

Comparative Studies ◽

Prostatic Hyperplasia ◽

Matched Pair ◽

Open Prostatectomy ◽

Randomized Controlled Studies ◽

Prostatic Artery

Introduction:Prostatic artery embolization (PAE) was introduced in the 1970s to control major bleeding after prostate surgery. The procedure was noticed to improve the lower urinary tract symptoms of benign prostatic hyperplasia (BPH) and in 2010, PAE was first investigated as an alternative treatment for BPH. A rapid health technology assessment (HTA) was carried out to inform our hospital's decision on introducing this procedure.Methods:The rapid HTA investigated the safety and clinical effectiveness of PAE for patients with BPH. The PICO elements were: Population- Patients with symptomatic BPH; Intervention- PAE; Comparator- Conventional management; Outcomes- Adverse effects, clinical outcomes. The NHS Centre for Reviews & Dissemination databases, Cochrane Database of Systematic Reviews, and PubMed (MEDLINE) were searched for systematic reviews and HTA reports.Results:Eight systematic reviews from the most recent two years were found. The primary evidence base consists of two randomized controlled studies of PAE versus transurethral resection of the prostate (TURP), one matched pair analysis of PAE versus open prostatectomy in patients with large prostates, and several non-comparative studies. The comparative studies showed patients had better International Prostate Symptom score, quality of life and reduced prostate volume with TURP and open prostatectomy from 1 to 24 months. With respect to adverse events, embolized patients had more adverse events than controls, particularly acute urinary retention and post-embolization syndrome. However, controls had more abnormal ejaculation; and adverse effects from surgery naturally only occurred in controls.Conclusions:PAE appears to be a promising technology lacking long term outcomes. It has potential for patients who are not fit or not keen on surgery, or who may have large prostates, but who are still vascularly suitable for embolization. It would be suitable to carry out under clinical research conditions to clarify the incremental benefits of the technology and which patient groups are best served by the procedure.

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