Comparison of early and late results of open and laparoscopic retropubic prostatectomy in surgical treatment of benign prostatic hyperplasia.

OBJECTIVE

Aim: To compare and evaluate the early and late results of open and laparoscopic retropubic prostatectomy in the surgical treatment of large benign prostatic hyperplasia (more than 80 ml).

PATIENTS AND

METHODS

Materials and

Methods

There were 50 one-stage laparoscopic extraperitoneal retropubic prostatectomies and 120 one-stage open retropubic prostatectomies performed in patients with benign prostatic hyperplasia in the urology department of the Vinnytsia Regional Hospital named after M. I. Pirogov in the period from 2021 to 2023. Indications for surgery in patients were: acute (including repeated) retention of urine; pronounced symptoms of the disease due to the lack of effect from conservative therapy; repeated hematuria, which is caused by BPH; bladder stones; recurrent infections of the urinary tract (cystitis, pyelonephritis) due to BPH. Patients with and suspected prostate cancer were excluded from the study. All patients were surveyed to determine IPSS indices and quality of life (QOL) of the International Prostate Symptoms Questionnaire, digital rectal examination, laboratory tests.

RESULTS

Results

The average time of laparoscopic prostatectomy - 120.3 ÷ 11.7 minutes, open - 81.1 ≤ 17.4; average intraoperative blood loss - 118.7 ÷ 33.6 ml and 520.5 ÷ 67.4 ml, postoperative bed-day 6.1 ÷ 1.1 and 9.8 $ 2.9, respectively. Transfusion of blood components - in 9 (7.5%) patients after open retropubic prostatectomy, never after laparoscopic. Urological complications after laparoscopic prostatectomy - in 2% of patients, open - 19.2%, complications according to Clavien - Dindo - 4% and 33.3%, respectively. Laparoscopic and open retropubic nrostatectomies allow eduall effective restoration of the art of urination after surgerv late results of treatment and postoperative complications were less (2.5% versus 8%) after laparoscopic retropubic prostatectomy.

CONCLUSION

Conclusions

Laparoscopic and open retropubic prostatectomy are effective operations for the treatment of patients with benign prostatic hyperplasia of large size (more than 80 ml) with satisfactory early and late results, as well as restoration of urination. In the hands of an experienced laparoscopic surgeon, laparoscopic retropubic prostatectomy can achieve better treatment results, than open retropubic prostatectomy. This makes it possible to recommend laparoscopic retropubic prostatectomy in the practice of urologists of urological clinics of Ukraine where laparoscopic equipment are present.