Is laparoscopic bladder diverticulectomy after transurethral resection of the prostate safe and effective? Comparison with open surgery.
OBJECTIVE
In a retrospective nonrandomized study, we compared our experience with transurethral resection of the prostate (TURP) plus sequential laparoscopic bladder diverticulectomy with a series of combined open bladder diverticulectomies with transvesical prostatectomy.


METHODS
We considered 12 consecutive patients (group A) having 16 diverticula who underwent sequential TURP and transperitoneal laparoscopic bladder diverticulectomy and 13 consecutive patients (group B) having 13 diverticula who underwent open bladder diverticulectomy and transvesical prostatectomy. We evaluated the size and position of the diverticulum, adenoma volume, operative time, postoperative hemoglobin variations, analgesia requirement, complications, postoperative hospital stay, and uroflowmetry results.


RESULTS
No statistically significant differences existed between the groups in adenoma volume or diverticulum size or position. However, a significantly longer operative time was recorded in group A. The endolaparoscopic approach proved to be statistically superior to open surgery regarding blood loss, postoperative analgesia requirement, and hospital stay. No intraoperative complications were recorded. In addition, no statistically significant difference was found in uroflowmetry results.


CONCLUSIONS
In our experience, the endolaparoscopic approach has proved to be safe, effective, and minimally invasive and therefore superior to transvesical prostatectomy and open bladder diverticulectomy. Its only disadvantage is the longer operative time.
Porpiglia
F
F
Divisione Universitaria di Urologia, Dipartimento di Scienze Cliniche e Biologiche, Azienda Ospedaliera S Luigi, Orbassano, Torino, Italy. porpiglia@libero.it
Tarabuzzi
R
R
Cossu
M
M
Vacca
F
F
Terrone
C
C
Fiori
C
C
Scarpa
R M
RM
D004240:Diverticulum / Q000473:pathology / Q000601:surgery*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D011183:Postoperative Complications; D011468:Prostatectomy / Q000379:methods; D011470:Prostatic Hyperplasia / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D012449:Safety; D020728:Transurethral Resection of Prostate; D016896:Treatment Outcome; D001745:Urinary Bladder Diseases / Q000473:pathology / Q000601:surgery*; D014563:Urodynamics
D006454:Hemoglobins