An alternative minimally invasive technique for large prostates (>80 mL): transvesical prostatectomy through a 3-cm incision.
OBJECTIVE
To assess the efficacy and the simplicity of a modified open transvesical prostatectomy for large prostates (>80 mL).


METHODS
A total of 165 patients with benign prostatic hyperplasia were treated with transvesical prostatectomy through a 3-cm incision. Prostate size was 85-144 cm(3) (mean 101 cm(3)). Surgery is performed as the standard transvesical prostatectomy but skin incision is much smaller (approximately 3 cm), whereas muscle incision underneath is about 7 cm long. Prostate adenoma was removed with finger dissection without the placement of hemostatic sutures.


RESULTS
Operation time was 15-36 minutes (mean 24 minutes). Catheter was removed on the third day and patients left the hospital after successful voiding. Preoperative hematocrit was 40.6-49.2 (mean 43.4), while postoperative hematocrit was 28.3-42.4 (mean 38.3). Transfusion rate was 0-3 blood units (mean 1 U). Mean preoperative flow was 11.5 cm/s and mean postoperative flow was 22.3 cm/s. Mean IPSS score improve from 28 preoperatively to 15 postoperatively.


CONCLUSIONS
Open transvesical prostatectomy with a 3-cm incision is a minimally invasive technique for the treatment of large prostates (>80 mL) in which transurethral prostatectomy or laser prostatectomy may not be the first choice.
Protogerou
Vassilis
V
Urological Department, IASO General Hospital, Athens, Greece. Vassilis_protogerou@hotmail.com
Argyropoulos
Vassilis
V
Patrozos
Kostas
K
Tekerlekis
Panagiotis
P
Kostakopoulos
Athanassios
A
D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D009929:Organ Size; D011468:Prostatectomy / Q000379:methods*; D011470:Prostatic Hyperplasia / Q000473:pathology* / Q000601:surgery*; D001743:Urinary Bladder