[Endoscopic treatment of the benign prostatic hyperplasia with local anesthesia and sedation in patients with high surgical or anaesthesical risk].
OBJECTIVE
[corrected] The aging of the population causes an increase of the number of men affected by benign prostatic hyperplasia (BPH) with a large number of pathology associated that may limit its surgical treatment. In this study we try to show the effectiveness and security of local anaesthesia and sedation in the endoscopic treatment of the BPH in patients with high surgical-anaesthetic risk.


METHODS
During the last 4 years, 38 patients underwent surgical treatment of BPH with ages between 78 and 86 years (average 81,4 +/- 3,2) with severe obstructive prostatic syndrome and high surgical-anaesthetic risk. 15 patients underwent, transurethral incision of prostate (TUIP) and in 23 patients, transurethral resection (TURP) was performed. The blockade anesthetic was made by transrectal periprostatic infiltration finger-guided with 10-15 millilitres of lidocaine 2%. During the procedure an intravenous perfusion of propofol and remifentanil was administered. The obtained results as well as the patient's satisfaction degree was evaluated by means of the elaboration of a questionnaire.


RESULTS
The average length of the surgical treatment was of 12 +/- 5 minutes (rank 8 - 25), having itself not stated complications derived from the anesthetic technique. They referred a slight annoyance 4 patients (11%) that was treated increasing the rate of the sedative perfusión. The satisfaction's degree with the received treatment has been good in the 95% of patients.


CONCLUSIONS
We considered that the TUIP as much as TURP made under local anesthesia with sedation are safe, effective methods and well tolerated, that fundamentally are indicated in aged patients and when the surgical-anesthetic risk is elevated.
Navalón Verdejo
P
P
Servicio de Urología, Hospital Casa de Salud, Valencia. pedronavalon@yahoo.com
Sánchez Ballester
F
F
Ordoño Dominguez
F
F
Pallás Costa
Y
Y
Juan Escudero
J
J
Cánovas Ivorra
J A
JA
D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local; D016292:Procedural Sedation; D004724:Endoscopy; D006801:Humans; D008297:Male; D011470:Prostatic Hyperplasia / Q000601:surgery*; D012307:Risk Factors