title: Open suprapubic versus retropubic prostatectomy in the treatment of benign prostatic hyperplasia during resident's learning curve: a randomized controlled trial.
abstract: OBJECTIVE
  This study compared the suprapubic (SP) versus retropubic (RP) prostatectomy for the treatment of large prostates and evaluated perioperative surgical morbidity and improvement of urinary symptoms.
  
  
  METHODS
  In this single centre, prospective, randomised study, 65 consecutive patients with LUTS and surgical indication with prostate volume greater than 75g underwent open prostatectomy to compare the RP (32 patients) versus SP (33 patients) technique.
  
  
  RESULTS
  The SP group exhibited a higher incidence of complications (p=0.002). Regarding voiding pattern analysis (IPSS and flowmetry), both were significantly effective compared to pre-treatment baseline. The RP group parameters were significantly better, with higher peak urinary flow (SP: 16.77 versus RP: 23.03mL/s, p=0.008) and a trend of lower IPSS score (SP: 6.67 versus RP 4.14, p=0.06). In a subgroup evaluation of patients with prostate volumes larger than 100g, blood loss was lower in those undergoing SP prostatectomy (p=0.003). Patients with prostates smaller than 100g in the SP group exhibited a higher incidence of low grade late complications (p=0.004).
  
  
  CONCLUSIONS
  The SP technique was related to a higher incidence of minor complications in the late postoperative period. High volume prostates were associated with increased bleeding when the RP technique was utilized. The RP prostatectomy was associated with higher peak urinary flow and a trend of a lower IPSS Score.
authors.affiliation: Hospital Israelita Albert Einstein, SP, Brasil.|Departamento de Urologia, Faculdade de Medicina do ABC, São Paulo, Brasil.
authors.forename: Arie
authors.initials: A
authors.lastname: Carneiro
authors.affiliation: Departamento de Urologia, Faculdade de Medicina do ABC, São Paulo, Brasil.
authors.forename: Paulo
authors.initials: P
authors.lastname: Sakuramoto
authors.affiliation: Hospital Israelita Albert Einstein, SP, Brasil.|Departamento de Urologia, Faculdade de Medicina do ABC, São Paulo, Brasil.
authors.forename: Marcelo Langer
authors.initials: ML
authors.lastname: Wroclawski
authors.affiliation: Departamento de Urologia, Faculdade de Medicina do ABC, São Paulo, Brasil.
authors.forename: Pedro Herminio
authors.initials: PH
authors.lastname: Forseto
authors.affiliation: Departamento de Urologia, Faculdade de Medicina do ABC, São Paulo, Brasil.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Den Julio
authors.affiliation: Departamento de Urologia, Faculdade de Medicina do ABC, São Paulo, Brasil.
authors.forename: Carlos Ricardo Doi
authors.initials: CR
authors.lastname: Bautzer
authors.affiliation: Departamento de Urologia, Faculdade de Medicina do ABC, São Paulo, Brasil.
authors.forename: Leonardo Monte Marques
authors.initials: LM
authors.lastname: Lins
authors.affiliation: Departamento de Urologia, Faculdade de Medicina do ABC, São Paulo, Brasil.
authors.forename: Andre
authors.initials: A
authors.lastname: Kataguiri
authors.affiliation: Departamento de Urologia, Faculdade de Medicina do ABC, São Paulo, Brasil.
authors.forename: Fernanda Batistini
authors.initials: FB
authors.lastname: Yamada
authors.affiliation: Departamento de Urologia, Faculdade de Medicina do ABC, São Paulo, Brasil.
authors.forename: Gabriel Kushiyama
authors.initials: GK
authors.lastname: Teixeira
authors.affiliation: Departamento de Urologia, Faculdade de Medicina do ABC, São Paulo, Brasil.
authors.forename: Marcos
authors.initials: M
authors.lastname: Tobias-Machado
authors.affiliation: Departamento de Urologia, Faculdade de Medicina do ABC, São Paulo, Brasil.
authors.forename: Antonio Carlos Lima
authors.initials: AC
authors.lastname: Pompeo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D007431:Intraoperative Complications; D059032:Learning Curve; D059411:Lower Urinary Tract Symptoms / Q000601:surgery; D008297:Male; D008505:Medical Staff, Hospital / Q000193:education; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications; D011446:Prospective Studies; D011467:Prostate / Q000601:surgery; D011468:Prostatectomy / Q000009:adverse effects / Q000193:education / Q000379:methods*; D011470:Prostatic Hyperplasia / Q000601:surgery*; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome