Trial of complete detachment of the whole prostate lobes in benign prostate hyperplasia by transurethral enucleation of the prostate.
BACKGROUND
We tried a complete detachment of the whole prostate lobes for benign prostate hyperplasia (BPH) by transurethral enucleation of the prostate (TUE). The feasibility of a new modified TUE technique (transurethral detaching prostatectomy = TUDP) was assessed by retrospective analysis.


METHODS
For 46 BPH cases the whole prostate lobes were detached from the surgical capsule completely by a prostate-detaching blade and resectoscope beak, and dropped into the bladder. The detached prostate lobes were removed by a soft tissue morcellator. The preoperative total prostate and adenoma volume by transabdominal ultrasound measurement (TAUS) were 47.75 +/- 25.63 and 27.8 +/- 17.33 ml.


RESULTS
In all 46 BPH cases, the whole prostate lobes could be detached completely without a perforation. Transurethral resection (TUR) syndrome and blood transfusion were not seen. Operation time was 54.28 min. The mean of removed tissue weight, that of hemoglobin loss and that of decrease of serum sodium was 37.11 g, 1.65 mg/dl and 1.56 mEq/l, respectively. Postoperative prostate volume and PSA were decreased to 9.56 ml and 0.8 ng/ml with complete removal of an adenoma.


CONCLUSIONS
TUDP could achieve complete removal of even a large adenoma without perforation, transurethral resection syndromes and blood transfusion safety.
Hiraoka
Yasunori
Y
Department of Urology, Tama-Nagayama Hospital, Nippon Medical School, Tokyo, Japan. hiraokay@nms.ac.jp
Shimizu
Yuji
Y
Iwamoto
Kazuya
K
Takahashi
Hirohumi
H
Abe
Hiroyuki
H
D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000601:surgery*; D011468:Prostatectomy / Q000379:methods*; D011470:Prostatic Hyperplasia / Q000601:surgery*; D012189:Retrospective Studies