Лапароскопічна екстраперитонеальна залобкова (транскапсулярна) простатектомія та симультанна передочеревинна герніопластика сітчастим імплантом у хворого іх доброякісною гіперплазією простати та пахвинною грижею

Abstract

Nowadays, an alternative treatment option for benign prostatic hyperplasia is laparoscopic and robotic methods, in contrast to the traumatic nature of open prostatectomy, a significant percentage of intra- and postoperative bleeding from the prostate fossa with the need for blood transfusions, pronounced pain syndrome in the postoperative wound with the possibility of suppuration, significant postoperative hospital-day and rehabilitation period. Along with the significant prevalence of inguinal hernias in 3-25% of patients, the possibility of onemoment simultaneous hernioplasty during prostatectomy for benign prostatic hyperplasia is an actual issue in both urology and abdominal surgery. A successful case of laparoscopic extra-peritoneal retropubic prostatectomy and pre-peritoneal hernioplasty with a mesh implant in a patient with benign prostatic hyperplasia and a right-sided indirect inguinal hernia (RL3) is presented. The volume of the prostate was 146 cm3. In the first stage, the patient underwent a laparoscopic extra-peritoneal one-moment transcapsular prostatectomy, in the second stage, a right-sided pre-peritoneal inguinal hernioplasty with a polypropylene mesh implant 10x15 cm of size. The duration of the operation was 200 minutes, intraoperative blood loss – 200 g. In the postoperative period, the urinary bladder was irrigated with an antiseptic solution for 1 day, the urethral catheter was removed on the 5th day. The patient was discharged on the 6th day with restored and satisfactory urination. Further studies are needed to establish the advantages of laparoscopic extra-peritoneal pubic prostatectomy and simultaneous pre-peritoneal hernioplasty in patients with benign prostatic hyperplasia and inguinal hernia.