title: Laparoscopic simple prostatectomy with prostatic urethra preservation for benign prostatic hyperplasia.
abstract: OBJECTIVE
  Laparoscopic simple prostatectomy for large volume benign prostatic hyperplasia (BPH) has been reported in the literature and may be a viable alternative to open surgery for large prostate glands. While previous publications have shown comparable outcomes between laparoscopic and open simple prostatectomy, there have been few publications describing improved laparoscopic operative technique to further improve these outcomes. The authors describe a novel technique of prostatic urethra preservation during laparoscopic simple prostatectomy.
  
  
  METHODS
  From January 2006 to September 2009, laparoscopic simple prostatectomy with prostatic urethra preservation was performed in 51 patients with symptomatic BPH. This technique included extraperitoneal insufflation of the retropubic space by balloon dilation, placement of five trocars in an inverted U shape, transverse prostatic capsular incision, development of a subcapsular plane, and removal of prostatic adenoma with preservation of the prostatic urethra followed by suturing of the prostatic capsule. Demographic, perioperative and outcome data were recorded.
  
  
  RESULTS
  The mean operative time was 126±51.98 min and the estimated blood loss was 232.55±199.54 mL. Significant improvements were noted in the International Prostate Symptom Score (IPSS), quality of life (QOL) questionnaires and maximum flow rate (Qmax) of patients three months after surgery. No incontinence was reported in any patient. Moreover, there was no significant difference in the 5-Item International Index of Erectile Function (IIEF-5) score pre- and post- operatively in patients who had erectile function before surgery and no patient complained of retrograde ejaculation during the postoperative follow-up period.
  
  
  CONCLUSIONS
  Laparoscopic simple prostatectomy with prostatic urethra preservation for benign prostatic hyperplasia is feasible and reproducible. With this technique, postoperative morbidity can be reduced and antegrade ejaculation preserved.
authors.affiliation: 1 Department of Urology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China ; 2 Department of Urology, Peking University First Hospital, and Institute of Urology, Peking University, National Research Center for Urological Cancer, Beijing 100034, China.
authors.forename: Nianzeng
authors.initials: N
authors.lastname: Xing
authors.affiliation: 1 Department of Urology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China ; 2 Department of Urology, Peking University First Hospital, and Institute of Urology, Peking University, National Research Center for Urological Cancer, Beijing 100034, China.
authors.forename: Yinglu
authors.initials: Y
authors.lastname: Guo
authors.affiliation: 1 Department of Urology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China ; 2 Department of Urology, Peking University First Hospital, and Institute of Urology, Peking University, National Research Center for Urological Cancer, Beijing 100034, China.
authors.forename: Feiya
authors.initials: F
authors.lastname: Yang
authors.affiliation: 1 Department of Urology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China ; 2 Department of Urology, Peking University First Hospital, and Institute of Urology, Peking University, National Research Center for Urological Cancer, Beijing 100034, China.
authors.forename: Long
authors.initials: L
authors.lastname: Tian
authors.affiliation: 1 Department of Urology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China ; 2 Department of Urology, Peking University First Hospital, and Institute of Urology, Peking University, National Research Center for Urological Cancer, Beijing 100034, China.
authors.forename: Junhui
authors.initials: J
authors.lastname: Zhang
authors.affiliation: 1 Department of Urology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China ; 2 Department of Urology, Peking University First Hospital, and Institute of Urology, Peking University, National Research Center for Urological Cancer, Beijing 100034, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Yan
authors.affiliation: 1 Department of Urology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China ; 2 Department of Urology, Peking University First Hospital, and Institute of Urology, Peking University, National Research Center for Urological Cancer, Beijing 100034, China.
authors.forename: Ning
authors.initials: N
authors.lastname: Kang
authors.affiliation: 1 Department of Urology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China ; 2 Department of Urology, Peking University First Hospital, and Institute of Urology, Peking University, National Research Center for Urological Cancer, Beijing 100034, China.
authors.forename: Zhongcheng
authors.initials: Z
authors.lastname: Xin
authors.affiliation: 1 Department of Urology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China ; 2 Department of Urology, Peking University First Hospital, and Institute of Urology, Peking University, National Research Center for Urological Cancer, Beijing 100034, China.
authors.forename: Yinong
authors.initials: Y
authors.lastname: Niu
keywords: Benign prostatic hyperplasia; laparoscopy; prostate; prostatectomy
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