Abstract
ABSTRACTObjective:To protect the urethra from instrumentation related urethra injures and stricture, we developed a new surgical technique which can be defined as transvesical resection of prostate without using urethra.Materials and Methods:Our study included 12 consecutive bladder outlet obstruction patients treated with transvesical prostate resection in our clinic between March 2016 and May 2016. Detailed anamnesis, results of physical examination, digital rectal examination, routine lab tests, international prostate symptoms score, transrectal ultrasound, measurement of prostate-specific antigen levels and uroflowmetry was performed in all patients prior to surgery.Results:Hospitalization period following surgery was 1 day. Foley catheter and suprapubic cystostomy catheters were removed in a median period of 3.6 days and 1 day. Median mass of resected adenomas was measured as 21.8 gr. Median maximum flow rate was measured as 6mL/s. Median postvoid residual urine volume was 70.6 cc and median international prostate symptoms score and quality of life scores were 9 and 1.4, respectively.Conclusion:In this study, we would like to show the possible practicality of transvesical resection of prostate technique in this patient group. However, we think that this technique is very useful in special patient groups such as patients with bladder stones, priapism and penile prosthesis.
Highlights
Bladder outlet obstruction (BOO) is a common condition seen in males over 40 and its incidence rate shows an increase with age
When surgical intervention techniques are considered, a transurethral prostate incision is used in patients with prostate volumes < 30 cc, and a transurethral prostate resection (TURP) is chosen for patients with prostate volumes between 30 and 80 cc
In daily practice, difficulties are experienced in special situations where transurethral prostatectomy is a challenge, such as with patients with penile prosthesis, patients with bladder stones, patients who develop priapism during surgery, and patients who cannot be positioned due to hip issues
Summary
Bladder outlet obstruction (BOO) is a common condition seen in males over 40 and its incidence rate shows an increase with age. Surgical intervention is recommended for patients who did not benefit from medical treatment or for patients with BOO - related complications such as recurring urinary tract infections, acute retention, hematuria, and bladder stones [2]. When surgical intervention techniques are considered, a transurethral prostate incision is used in patients with prostate volumes < 30 cc, and a transurethral prostate resection (TURP) is chosen for patients with prostate volumes between 30 and 80 cc. An open ibju | Transvesical resection of prostate prostatectomy procedure is recommended for patients with prostate volumes > 80 cc [3]. All the surgical techniques mentioned above have different early - and late - term complication risks. A new technique (transvesical prostate resection) for prostate resection is defined and its outcomes and practicality are assessed (Figure-1)
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