Open suprapubic versus retropubic prostatectomy in the treatment of benign prostatic hyperplasia during resident's learning curve: a randomized controlled trial

Carneiro, Ariê; Sakuramoto, Paulo Kouiti; Wroclawski, Marcelo Langer; Forseto, Pedro H.; Julio, Alexandre Den; Bautzer, Carlos Ricardo Doi; Lins, Leonardo Monte Marques; Kataguiri, André; Yamada, Fernanda Batistini; Teixeira, Gabriel Kushiyama; Tobias-Machado, Marcos; Pompeo, Antônio Carlos Lima

doi:10.1590/s1677-5538.ibju.2014.0517

Cited by 19 publications

(19 citation statements)

References 19 publications

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“…The modified Clavien system popularized by Dindo et al [7] was used to classify the complications from our study ( Table 2). Other researchers have equally embraced it to assess their outcome after OP surgery [6] [16] [22]. The grade II complications were the most common from our study, of which the commonest was haemorrhage, similar to reports by other researchers [9] [16] [22].…”

Section: Discussionsupporting

confidence: 87%

“…However, inadequate equipment and expertise on HoLEP and other novel minimal access techniques that can cater for large prostate volume make OP the only viable option for majority of BPH patients in our environment. When compared with endoscopic treatment, OP is cheaper, more effective [6] and can be used to simultaneously treat complications such as bladder diverticulum and bladder calculi, which are relatively common in most developing countries due to late presentation of patients [2].…”

Section: Introductionmentioning

confidence: 99%

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Open Prostatectomy in the Management of Benign Prostate Hyperplasia in a Developing Economy

Salako¹,

Badmus²,

Owojuyigbe³

et al. 2016

OJU

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Background: Open prostatectomy (OP) is still relatively common in developing countries and remains a useful benchmark against which the minimal access surgical techniques are compared. This study aims to document the indications and outcomes of OP in a typical developing economy. Method: The records of patients with benign prostate hyperplasia (BPH) who had OP in our university teaching hospital between July 2004 and June 2014 were retrospectively reviewed. Some analyzed parameters include the demographic characteristics, indications, pre-operative work-up, anaesthetic techniques, OP type, complications, histopathology results and follow-up duration. Results: A total of 247 cases were studied. Mean age was 67 years while the commonest surgery indication was recurrent acute urinary retention. Average prostate specific antigen (PSA) was 8.4 ng/ml while hypertension was the most common co-morbidity (44.1%). Regional anaesthesia was mainly used (79.4%) while retropubic prostatectomy was the commonest OP type done (58.7%). The enucleated specimen weighed above 60 g in 91.9% of cases. All our patients were able to micturate spontaneously with urine stream above 20 mls/second on follow-up one week after discharge. Mean duration of hospital admission and follow-up were 7 days and 9 months respectively. Complications occurred in 90 patients (36.4%), of which surgical site infections were the commonest (9.8%). There was 0.4% mortality. Histopathology results showed BPH (95.5%), (incidental) prostate adenocarcinoma (2.4%) or prostatic intra-epithelial neoplasia (2.1%). Conclusion: OP remains an important therapeutic option for management of BPH in developing countries partly due to relatively large prostate size and presence of BPH complications from late presenta-#

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Open Prostatectomy in the Management of Benign Prostate Hyperplasia in a Developing Economy

Salako¹,

Badmus²,

Owojuyigbe³

et al. 2016

OJU

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“…Both procedures are relatively safe and quite effective. Nevertheless, the classical monopolar TURP may be related to TURP syndrome (hyponatremia caused by the absorption of irrigation fluid) and open SP may present significant complication rates such as bleeding and long hospital stay (Carneiro et al., 2016).…”

Section: Introductionmentioning

confidence: 99%

Anatomical endoscopic enucleation of the prostate: The next gold standard? No! (or not yet!)

2020

Self Cite

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Most cases of lower urinary tract symptoms due to benign prostatic hyperplasia are initially managed through medical therapy. In cases that surgery is indicated, the anatomical endoscopic enucleation of the prostate (aEEP), first described in 1983, allegedly presents the same safety profile as the best endoscopic non-enucleating procedures and the same long-term functional outcomes as simple prostatectomy. Thus, why aEEP has not yet been consolidated as the gold-standard BPH surgical treatment? The main reasons are as follows: (a) Multiple energy sources and techniques; (b) High costs; (c) Steep learning curve; (d) Rare in-residency training; (e) Reimbursement issues; (f) Outcomes and (g) Complications. We do believe aEEP is an important advance and a "practice-changing" procedure that will play an important role in the BPH surgical options arsenal, especially for larger prostates. However, there is a need to start an in-residency training program, with a mentor guidance, and, over time, the cost will likely be reduced due to greater competition between companies and greater support from health insurers. Considering these points, in the future, EEP may be considered the gold-standard treatment for BPH… but not yet. K E Y W O R D S endoscopic surgical procedure, prostate, prostatic hyperplasia, standard of care, urologic surgical procedures How to cite this article: Wroclawski ML, Teles SB, Carneiro A. Anatomical endoscopic enucleation of the prostate: The next gold standard? No! (or not yet!). Andrologia.

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“…Benign prostatic hyperplasia (BPH) affects more than 50% of men over 60 years of age and is the most common cause of bladder outlet obstruction and voiding symptoms in elderly men. 1,2 BPH is characterized by lower urinary tract symptoms (LUTS) and sometimes may be associated with urinary incontinence and sexual dysfunction. Apart from the daily misery of these symptoms, if patients seek medical advice late, they could also suffer from complications, such as uri-nary tract infection (UTI), pyelonephritis, stone formation, hydronephrosis, and even renal failure.…”

Section: Introductionmentioning

confidence: 99%

A descriptive study of transvesical prostatectomy outcomes at a general hospital in Addis Ababa, Ethiopia

Seife¹,

Deneke²

2018

East. Cent. Afr. J. Surg.

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Background Benign prostatic hyperplasia (BPH) affects more than 50% of men over 60 years of age and is the most common cause of bladder outlet obstruction and voiding symptoms in elderly men. Open prostatectomy-either transvesical or retropubic-remains the standard definitive treatment for BPH in some centres, especially in developing countries. Methods This study was undertaken at Ras Desta Hospital, a regional hospital run by the Addis Ababa Health Bureau. The study was conducted between 1 January 2011 and 31 December 2013, during which time 195 patients underwent surgery for BPH. Of these, 154 patients had preoperative and postoperative records sufficient for comparison and analysis. Data were analysed using SPSS version 20. Results Fourteen patients (9%) were between 40 and 49 years of age, 41 (27%) were 50 to 59 years old, and 67 patients (44%) were between 60 and 69 years of age. Sixty-one of the patients (40%) of patients had one or more episodes of acute urinary retention and had a history of catheterization for bladder outlet obstruction. Immediate postoperative complications were seen in 10 patients. Two patients had transient incontinence after transvesical prostatectomy, and 1 patient had permanent incontinence. There was also 1 clot retention, 2 suprapubic leaks, and 4 wound infections. One patient reported retrograde ejaculation. Conclusions Given the limited availability and high costs associated with transurethral resection of the prostate, open prostatectomy remains an appropriate alternative in Ethiopia. The complication rates associated with open prostatectomy are minimal when the procedure is performed by adequately trained personnel. However, BPH patients often present to hospital after several serious complications. Therefore, more efforts should be made towards improving community awareness.

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Open suprapubic versus retropubic prostatectomy in the treatment of benign prostatic hyperplasia during resident's learning curve: a randomized controlled trial

Cited by 19 publications

References 19 publications

Open Prostatectomy in the Management of Benign Prostate Hyperplasia in a Developing Economy

Open Prostatectomy in the Management of Benign Prostate Hyperplasia in a Developing Economy

Anatomical endoscopic enucleation of the prostate: The next gold standard? No! (or not yet!)

A descriptive study of transvesical prostatectomy outcomes at a general hospital in Addis Ababa, Ethiopia

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