title: Laparoscopic Madigan prostatectomy.
abstract: OBJECTIVE
  Laparoscopic Madigan prostatectomy have not been reported yet. We modified the Madigan prostatectomy to make it suitable for laparoscopically enucleating hyperplastic glands larger than 100 g.
  
  
  METHODS
  Between May 2007 and Oct 2008, extraperitoneal laparoscopic prostatectomy with maintenance of the intact urethra had been performed on 16 patients with benign prostatic hyperplasia (BPH) and glands larger than 100 mg. To make it suitable for laparoscopic use, two major modifications had been made: (1) Open the prostate capsule near the bladder neck without sutures along the opening; (2) identify the bladder neck mucosa before recognizing the urethra. All patients were evaluated preoperatively and postoperatively. Data were compared with those from open surgeries.
  
  
  RESULTS
  All laparoscopic procedures were successful with the total operative time of 111.8±28.6 minutes, which had no significant difference compared with open surgeries. Estimated blood loss of laparoscopic procedures (112.5±47.8 mL) was significantly lower than that of open surgery. The catheterization time and hospital stay time was significantly shorter than open surgery. The improvement of the International Prostate Symptom Score, maximum flow rate, and quality-of-life score were not different between the comparing groups.
  
  
  CONCLUSIONS
  The laparoscopic Madigan prostatectomy is a safe and feasible approach for large glands (BPH). Furthermore, its advantages include shorter learning curve, reduced blood loss, less retroejaculation rate, shorter catheterization time, and shorter hospital stay.
authors.affiliation: Department of Urology, Tianjin Institute of Urology, Tianjin, China.
authors.forename: Changyi
authors.initials: C
authors.lastname: Quan
authors.forename: Wenliang
authors.initials: W
authors.lastname: Chang
authors.forename: Jing
authors.initials: J
authors.lastname: Chen
authors.forename: Bo
authors.initials: B
authors.lastname: Li
authors.forename: Yuanjie
authors.initials: Y
authors.lastname: Niu
mesh_terms: D000368:Aged; D004210:Dissection; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D008297:Male; D011182:Postoperative Care; D011300:Preoperative Care; D011468:Prostatectomy / Q000379:methods*; D013537:Sutures; D014521:Urethra / Q000601:surgery