title: Prospective study comparing laparoscopic and open adenomectomy: Surgical and functional results.
abstract: BACKGROUND
  Open adenomectomy (OA) is the surgery of choice for large volume benign prostatic hyperplasia, and laparoscopic adenomectomy (LA) represents a minimally invasive alternative. We present a long-term, prospective study comparing both techniques.
  
  
  METHODS
  The study consecutively included 199 patients with benign prostatic hyperplasia and prostate volumes>80g who were followed for more than 12 months. The patients underwent OA (n=97) or LA (n=102). We recorded and compared demographic and perioperative data, functional results and complications using a descriptive statistical analysis.
  
  
  RESULTS
  The mean age was 69.2±7.7 years (range 42-87), and the mean prostate volume (measured by TRUS) was 112.1±32.7mL (range 78-260). There were no baseline differences among the groups in terms of age, ASA scale, prostate volume, PSA levels, Qmax, IPSS, QoL or treatments prior to the surgery. The surgical time (P<.0001) and catheter time (P<.0002) were longer in the LA group. Operative bleeding (P<.0001), transfusion rate (P=.0015) and mean stay (P<.0001) were significantly lower in the LA group. The LA group had a lower rate of complications (P=.04), but there were no significant differences between the groups in terms of major complications (Clavien score≥3) (P=.13) or in the rate of late complications (at one year) (P=.66). There were also no differences between the groups in the functional postoperative results: IPSS (P=.17), QoL (P=.3) and Qmax (P=.17).
  
  
  CONCLUSIONS
  LA is a reasonable, safe and effective alternative that results in less bleeding, fewer transfusions, shorter hospital stays and lower morbidity than OA. LA has similar functional results to OA, at the expense of longer surgical times and longer catheter times.
authors.affiliation: Servicio de Urología, Hospital General Universitario de Elche, Elche, Alicante, España. Electronic address: agarciasegui@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Garcia-Segui
authors.affiliation: Servicio de Urología, Hospital Universitario de Getafe, Departamento Clínico, Universidad Europea de Madrid, Laureate Universities, Getafe, Madrid, España.
authors.forename: J C
authors.initials: JC
authors.lastname: Angulo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011470:Prostatic Hyperplasia / Q000601:surgery*; D016896:Treatment Outcome; D013521:Urologic Surgical Procedures, Male / Q000379:methods
keywords: Adenomectomy; Adenomectomía; Benign prostate hyperplasia; Calidad de vida; Complicaciones; Complications; Hipertrofia benigna de próstata; Laparoscopia; Laparoscopy; Prostate; Próstata; Quality of life; Resultados operativos; Surgical results