Endoscope-assisted radical perineal prostatectomy.
Dissection of the bladder neck is particularly important in patients who have previously had prostate surgery due to hyperplasia. We describe an endoscope-assisted radical perineal prostatectomy (RPP) technique that facilitates the dissection of the prostate-vesical junction. The technique was employed in four patients with a history of transurethral prostate resection. Before dissecting the prostate from the bladder neck during RPP, we circumscribed the bladder neck perurethrally with a Collins knife. The remaining of the RPP procedure was performed via the traditional approach. The incision of the prostate-vesical junction with the Collins knife protected the bladder-neck integrity and made the dissection of this junction easier. The final pathologic diagnosis was organ-confined prostate cancer with negative surgical margins. All the patients had continence during a 6-month follow-up. The major advantage of this technique is to precisely locate the prostate-vesical junction under direct vision. Our modified technique may prove to be a simple, less invasive, and oncologically safe method to manage the bladder neck perurethrally.
Department of Urology, Kartal Training and Research Hospital, Istanbul, Turkey.
Selami
S
Albayrak
Onder
O
Canguven
Huseyin
H
Aydemir
Cemal
C
Goktas
Cihangir
C
Cetinel
Oktay
O
Akca
D004210:Dissection; D019723:Endoscopes; D006801:Humans; D008297:Male; D010502:Perineum / Q000601:surgery*; D011467:Prostate / Q000601:surgery; D011468:Prostatectomy / Q000295:instrumentation* / Q000379:methods*; D014521:Urethra / Q000601:surgery; D001743:Urinary Bladder / Q000601:surgery