title: Single-port transvesical enucleation of the prostate for benign prostatic hyperplasia with severe intravesical prostatic protrusion.
abstract: OBJECTIVE
  To introduce the surgical techniques of a single-port transvesical enucleation of the prostate (STEP) for enlarged prostates with severe intravesical prostatic protrusion (IPP) presenting with lower urinary tract symptoms (LUTS).
  
  
  METHODS
  Our study included 7 patients with prostates larger than 80 mL and with severe IPP who underwent STEP. All the procedures were performed using a home-made single-port device through a 3-cm midline incision at the level three fingerbreadths above the symphysis pubis. Rigid laparoscopic instruments and Harmonic Scalpels(®) were used to enucleate the large adenoma of the prostate.
  
  
  RESULTS
  All the procedures were completed satisfactorily, with no intra and early postoperative complications. The mean resected prostatic weight was 54.14 ± 8.38 g, and the mean operative time was 191.86 ± 40.88 min. The mean time for catheterization was 5.29 ± 1.80 days. The postoperative 3-month international prostate symptoms score (IPSS) and maximal flow rate (Qmax) were improved following STEP (IPSS; 23.57 ± 2.15 vs. 11.43 ± 2.44, Qmax; 17.14 ± 3.44 mL/s vs. 6.71 ± 2.29 mL/s).
  
  
  CONCLUSIONS
  Laparoendoscopic single-site surgery (LESS) and enucleation of the prostate with rigid laparoscopic instruments might be difficult but is feasible. STEP may be a new treatment option for use in open prostatectomies for enlarged prostates with severe IPP in carefully selected patients.
authors: Department of Urology, Hanyang University College of Medicine, Seoul, Korea.
authors: Joo Yong
authors: JY
authors: Lee
authors: June Hyun
authors: JH
authors: Han
authors: Hong Sang
authors: HS
authors: Moon
authors: Tag Keun
authors: TK
authors: Yoo
authors: Hong Yong
authors: HY
authors: Choi
authors: Seung Wook
authors: SW
authors: Lee
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005240:Feasibility Studies; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D008297:Male; D018579:Patient Selection; D011467:Prostate / Q000473:pathology / Q000601:surgery*; D011468:Prostatectomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D011470:Prostatic Hyperplasia / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome