Results of open prostatectomy done due to absolute indications in course of benign prostatic hyperplasia
Article published in Urologia Polska 2008/61/1.

authors

Sławomir Dutkiewicz, Maciej Fortuna: Zakład Profilaktyki i Epidemiologii Onkologicznej Instytutu Promocji Zdrowia Wydziału Nauk o Zdrowiu Akademii
Świętokrzyskiej w Kielcach oraz Centrum ATTIS w Warszawie
Oddział Urologii Specjalistycznego Szpitala w Nowym Sączu

keywords

prostate, benign prostatic hyperplasia, surgical therapy, postoperative complications

summary

Introduction and the aim of the study. Surgical therapy in patients with benign prostatic hyperplasia (BPH) and particularly enlarged prostates remains the definitive treatment. We describe the clinical long-term results and complication rate after open prostatectomy in patients with absolute indications to surgery.

Materials and methods. We performed a prospective study in 58 patients with BPH who underwent trans-vesical prostatectomy from 1996 to 2001 at a single institution. The examinations were performed which estimated parameters before and after the treatment: LUTS (lower urinary tract symptoms) by IPSS (International Prostate Score Symptoms), QoL (Quality of life), Qmax (maximum urethral flow), PVR – post voided residual urine volume; serum PSA (Prostate Specific Antigen); time of hospitalization; early and late

complications.

Results. Patients were followed to 5 years postoperatively. All patients before surgery had recurrent AVR (acute urinary retention) even with medical therapy. There was significant improvement of all examined parameters: IPSS decreased from preoperative 29.3 points to 2.9 points, QoL – from 5.8 to 0.9 points, Qmax from AUR to 24,2 ml/s, PVR from 596.5 to 5.4 ml, PSA from 4,1 to 0.9 ng/ml. Medium hospitalization time was 17 days. As postoperatively, early and late complications were observed; 4 patients required blood transfusions, bleeding from the lodge – 4 pts , urosepsis – 4 pts, epidydymitis – 8 pts, suprapubic urinary fistula – 8 pts, temporary urine incontinence – 3 pts and urethra stricture – 2 pts.

Conclusions. 1. Open surgery – transvesical prostatectomy remains a method of treatment of patients with BPH especially of those operated because of absolute indications and in men with a large prostatic gland. 2. The results of our long-term prospective study demonstrate durable improvement in LUTS and urination in patients with BPH treatment following open prostatectomy.

references

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correspondence