scholarly journals Transient Occlusion of Bilateral Internal Iliac Arteries Facilitates Bloodless Operative Field in Subcapsular Prostatectomy

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Takumi Takeuchi ◽  
Masayoshi Zaitsu ◽  
Koji Mikami ◽  
Shunsuke Yui ◽  
Yuta Takeshima ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Benign Prostatic Hyperplasia ◽  
Transurethral Resection ◽  
Gold Standard ◽  
Prostatic Hyperplasia ◽  
Operative Field ◽  
Iliac Arteries ◽  
Prostatic Capsule ◽  
Internal Iliac ◽  
Internal Iliac Arteries

Transurethral resection of the prostate is the gold standard of surgical treatment for benign prostatic hyperplasia (BPH). Nevertheless, open subcapsular prostatectomy is still performed for large BPH. While enucleation of prostatic adenoma is being performed, unneglectable bleeding can occur and surgeons need to rush to remove adenomas, often using fingers and in a blinded fashion. The blood supply to the prostatic capsule and adenoma can be reduced to a marked extent in subcapsular prostatectomy if the bilateral internal iliac arteries are transiently occluded. Thus, a bloodless operative field is reasonably acquired during enucleation of adenoma, which would, otherwise, be a cause for concern to surgeons due to bleeding. It is not always applicable, but it could be an option if the estimated volume of BPH is more than 100 mL. In two cases, bilateral internal iliac arteries were occluded with Bulldog clamps, and then adenomas of 159 and 97 g were enucleated.

Evaluation of mid-term results of bipolar transurethral resection in the treatment of benign prostatic hyperplasia

2018 ◽  
pp. 1-9
Author(s):  
А.С. Векильян
Keyword(s):  
Surgical Treatment ◽  
Benign Prostatic Hyperplasia ◽  
Blood Loss ◽  
Endoscopic Surgery ◽  
Transurethral Resection ◽  
Operating Time ◽  
Clinical Results ◽  
Massive Bleeding ◽  
Prostatic Hyperplasia ◽  
Surgical Methods

Представлены клинические результаты хирургического лечения доброкачественной гиперплазии предстательной железы (ДГПЖ) объемом до 100 см3 методом биполярной трансуретральной резекции простаты (БТУР -74 пациента) в сравнении с открытой чреспузырной простатэктомией (ОПЭ - 96 пациентов), ранее применявшейся для подобных клинических случаев в урологической клинике "Железнодорожной больницы" г. Волгоград. При статистически равном операционном времени обоих хирургических методов для БТУР отмечено существенное снижение интраоперационной кровопотери, сроков послеоперационной катетеризации и пребывания в стационаре, минимальная частота геморрагических и инфекционно-воспалительных осложнений. Наблюдение за урологическим статусом пациентов в течение первого послеоперационного года показало одинаковую клиническую эффективность сравниваемых хирургических методов. Значительное снижение объема кровопотери в ходе операции БТУР можно считать большим достижением, поскольку улучшение видимости в зоне хирургического вмешательства позволяет оптимизировать гемостаз, предотвратить массивные кровотечения как во время, так и после операции, сократить сроки послеоперационной катетеризации мочевого пузыря, что в свою очередь, снижает частоту развития инфекционно-воспалительных осложнений. Более быстрое восстановление пациентов после эндоскопических операций имеет медико-социальное и экономическое значение, поскольку минимальное количество послеоперационных осложнений и сокращение сроков госпитализации позволяет существенно снизить затраты на лечение и быстрее нормализовать качество жизни пациентов. Полученные результаты демонстрируют перспективность внедрения биполярных методов эндоскопических операций для лечения ДГПЖ в хирургическую практику урологических стационаров в целях повышения безопасности оперативного лечения и экономии затрат на госпитализацию. The clinical results of surgical treatment of benign prostatic hyperplasia (BPH) up to 100 cm3 by bipolar transurethral resection of the prostate (BTUR - 74 patients) in comparison with open transvesical prostatectomy (OPE - 96 patients), previously used for such clinical cases in the urological clinic "Railway hospital" in Volgograd are presented. With statistically equal operating time of both surgical methods, there was a significant decrease in intraoperative blood loss, the terms of postoperative catheterization and hospital stay, the minimum frequency of hemorrhagic and infectious-inflammatory complications. Observation of the urological status of patients during the first postoperative year showed the same clinical efficacy of the compared surgical methods. A significant reduction in the volume of blood loss during the operation, can be considered a great achievement, since the improvement of visibility in the area of surgical intervention allows to optimize the hemostasis, to prevent massive bleeding during and after surgery, to reduce the duration of postoperative bladder catheterization, which, in turn, reduces the incidence of infectious-inflammatory complications. Faster recovery of patients after endoscopic surgery of medical,social and economic importance, as the minimum number of postoperative complications and reduction of hospitalization can significantly reduce the cost of treatment and quickly normalize the quality of life of patients. The results demonstrate the prospects of the introduction of bipolar methods of endoscopic surgery for the treatment of BPH in the surgical practice of urological hospitals in order to improve the safety of surgical treatment and save costs for hospitalization.

LASER TECHNOLOGIES IN SURGERY BENEFICIAL PROSTATE HYPERPLASIA

2021 ◽  
pp. 144-153
Author(s):  
Rakhimov S.A. ◽  
Feofilov I.V. ◽  
Arbuzov I.A.
Keyword(s):  
Surgical Treatment ◽  
Benign Prostatic Hyperplasia ◽  
Transurethral Resection ◽  
Prostate Gland ◽  
Prostatic Hyperplasia ◽  
Prostate Hyperplasia ◽  
Advantages And Disadvantages ◽  
Laser Technologies ◽  
Surgical Methods ◽  
Laser Systems

Benign prostatic hyperplasia is one of the most common diseases in urological practice. The classical method of surgical treatment of benign prostatic hyperplasia is transurethral resection of the prostate gland. However, this operation is accompanied by a fairly large number of postoperative complications and is not recommended for patients with a large prostate volume, with a high cardiovascular risk, and receiving anticoagulant therapy. In recent years, the medical community has been paying close attention to laser technologies. The article provides an overview of the literature on laser methods for the treatment of benign prostatic hyperplasia. Modern laser systems are considered: holmium, thulium, diode, «green» lasers. The advantages and disadvantages of each technique are described. The results of studies of the efficacy and safety of laser surgical methods for the treatment of benign prostatic hyperplasia and their influence on the indicators of urodynamics, symptoms of the disease, and the quality of life of patients are presented. Based on the analysis of scientific literature sources, it was concluded that laser methods of surgical treatment of benign prostatic hyperplasia are clinically effective and safe. Compared with transurethral resection of the prostate, laser technologies can shorten the period of hospitalization and catheterization of patients, have a low number of complications, provide good hemostasis, and can be used regardless of the volume of the gland in patients with concomitant diseases who are taking anticoagulants. Laser methods of surgical treatment of benign prostatic hyperplasia are currently a full-fledged worthy alternative to transurethral resection of the prostate gland. Among the disadvantages of using laser systems are the duration of the operation and the need to train specialists in the technique of surgical intervention.

scholarly journals A prospective comparative study on the operative outcomes between monopolar versus bipolar transurethral resection of prostate for benign prostatic hyperplasia: An institutional experience

2021 ◽  
Vol 12 (11) ◽  
pp. 125-132
Author(s):  
Vedamurthy Reddy Pogula ◽  
Ershad Hussain Galeti ◽  
Bhargava Reddy Kanchi V
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Transurethral Resection ◽  
Gold Standard ◽  
Urine Volume ◽  
Prostatic Hyperplasia ◽  
Common Disease ◽  
Transurethral Resection Of Prostate ◽  
Duration Of Surgery ◽  
The Mean ◽  
Dilutional Hyponatremia

Background: Benign prostatic hyperplasia (BPH) is a common disease in elderly men. Monopolar transurethral resection of prostate (M-TURP) is considered the gold standard for the treatment of bladder outlet obstruction due to BPH. Its modification, bipolar TURP (B-TURP), promises to overcome its most prominent drawbacks, such as bleeding and dilutional hyponatremia. Aims and Objectives: This study aims to study the feasibility, effectiveness, and safety of B-TURP over M-TURP. Materials and Methods: A total of 110 patients with BPH were prospectively randomly assigned to undergo B-TURP (55) or M-TURP (55). Patient characteristics of the two groups were similar. Hemoglobin was measured preoperatively and postoperatively. IPSS, maximal flow rate, and post-void residual urine volume were assessed preoperatively. Duration of surgery, mean weight of resected tissue, mean irrigation fluid used, mean drop in hemoglobin, mean change in sodium, and mean post-operative irrigation used were also compared. Results: Duration of resection time was significantly shorter in M-TURP (P=0.0034). The mean change in sodium and mean post-operative irrigation used were significantly lower in bipolar group with P<0.05 and 0.0024, respectively. The mean drop in post-operative hemoglobin concentration (P=0.0916) was statistically insignificant. There was one instance of the transurethral resection (TUR) syndrome in the M-TURP group whereas no TUR syndrome occurred in the B-TURP group. Conclusion: B-TURP and M-TURP are effective and safe techniques for the surgical treatment of BPH. B-TURP definitely reduces the incidence of dilutional hyponatremia and post-operative irrigation use making it a competitor to replace M-TURP as the new gold standard.

scholarly journals Gambaran Komplikasi Transurethral Resection of the Prostate pada Pasien Benign Prostatic Hyperplasia

2017 ◽  
Vol 10 (1) ◽  
pp. 44
Author(s):  
Zuhirman Zuhirman ◽  
Desby Juananda ◽  
Putry Lestari
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Transurethral Resection ◽  
Gold Standard ◽  
Medical Records ◽  
Benign Tumor ◽  
Descriptive Study ◽  
Prostatic Hyperplasia ◽  
Inclusion Criteria ◽  
The Mean ◽  
Age Range

Benign prostatic hyperplasia (BPH) is a benign tumor that most common, a serious problem and may affect thequality of life. Transurethral resection of the prostate (TURP) is the gold standard for BPH management. The aim ofthis study was to describe the complications of TURP in patients with BPH. This was a descriptive study by reviewingthe medical records of BPH patients underwent TURPs at RSUD Arifin Achmad, Riau Province in 2011-2015. Therewere 280 medical records fulfilled the inclusion criteria in which showed 93 patients who experienced complicationsof TURP. The most age range was 60-69 years old (12,9%), the mean of the resection duration was 30(10-80) minutesand the mean of weight of the resected prostatic tissue was 30 (10-50)grams. The most common complications wasbleeding (42,9%), urinary retention (27,6%).In the research, we conclude the complications were higher than theones in the literatures.

scholarly journals Choosing the surgical treatment method for benign prostatic hyperplasia

2013 ◽  
Vol 94 (3) ◽  
pp. 409-412
Author(s):  
R M Sitdykov ◽  
E N Shaidullin ◽  
A Y Zubkov
Keyword(s):  
Surgical Treatment ◽  
Benign Prostatic Hyperplasia ◽  
Urinary Bladder ◽  
Treatment Outcomes ◽  
Flow Rate ◽  
Transurethral Resection ◽  
Prostate Volume ◽  
Prostatic Hyperplasia ◽  
Transurethral Resection Of Prostate ◽  
Residual Urine

Aim. To assess the surgical treatment outcomes for benign prostatic hyperplasia. Methods. The surgical treatment outcomes for benign prostatic hyperplasia were analyzed in 72 patients. 44 patients underwent transvesical prostatectomy ended with blind urinary bladder stitch, 28 patients with a prostate volume of less than 60 ml were offered transurethral resection of prostate. The patients’ mean age was 73.6 years. Inclusion criteria were: average urination flow rate (Qav) 10 ml/sec, total international prostate symptom score (I-PSS) 19, residual urine volume 50 ml. Prostate volume ranged from 29 to 150 ml. All interventions were performed using regional anesthesia. The effect of surgical treatment was assessed 3 months after the surgery was performed. Results. Self urination was restored at 2-3rd day. All patients had no residual urine. Urine flow parameters in patients after transvesical prostatectomy were: maximum urination flow rate (Qmax) - 24±1.3 ml/sec, Qav - 11.6±1.1 ml/sec; in patients after transurethral resection of prostate: Qmax - 17.2±0.8 ml/sec, Qav - 11.4±1.2 ml/sec. I-PSS index in the transvesical prostatectomy group was 2.3±0.3 compared to 9.7±1.1 points in transurethral resection of prostate group. Irritative symptoms prevailed in patients from transurethral resection of prostate group, 23 (82%) of them have improved after 1 month treatment with α1-adrenoblockers. Conclusion. Transvesical prostatectomy ended with blind urinary bladder stitch is still a radical and effective option for benign prostatic hyperplasia surgical treatment. Transurethral resection of prostate is effective in patients with prostate volume less than 60 ml and requires additional medical correction of irritative symptoms during the postoperative period.

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