IMPRUVING HEMOSTASIS DURING ONESTAGE RETROPUBIC PROSTATECTOMY AND SIMULTANEUS PREPERITONEAL HERNIOPLASTIC IN PATIENTS WITH BENIGH PROSTATIC HYPERPLASIA AND INGUINAL HERNIAS

Abstract

Summary. Inguinal hernia is found in 2-8% of patients with benign prostatic hyperplasia. The possibility of simultaneous elimination of prostatic obstruction and inguinal hernia requires improvement of the method of hemostasis during the performance of recumbent prostatectomy in order to reduce blood loss and time of surgery is a pressing issue for both abdominal surgery and urology.
 Purpose of research. Improve the method of hemostasis in the performance of one-stage prostatectomy and simultaneous preabdominal plastic of inguinal hernia in patients with benign prostatic hyperplasia and inguinal hernia to reduce blood loss and time of operation.
 Materials and methods of research. Preabdominal plastic of the inguinal hernia during a single-stage concurrent prostatectomy was performed for 32 patients with benign prostatic hyperplasia. The first 6 patients, preperitoneal gernioplasty was performed before retropubic prostatectomy, for the last 26 patients - after a prostatectomy because of the possibility of loosening of the applied sutures at stretching of a wound by hooks.
 Research and discussion of results. In order to reduce bleeding during prostate prostatectomy and time of surgery, we proposed to perform hemostatic U-shaped catgut sutures (No. 6) on the lateral surfaces of the prostate capsule on muscle pieces (pads) of the pyramidal abdominal muscle. Intraoperative blood loss during surgery was determined by weight. The application of the hemostasis technique in the performance of a single-stage concurrent prostatectomy and simultaneous preperitoneal plasticity of inguinal hernias for patients with benign prostatic hyperplasia and inguinal hernia allowed to reduce the duration of surgery by 10-15 minutes, and blood loss by 150-250 ml.
 Conclusions. The results of improvement of the method of hemostasis in the performance of a single-stage concurrent prostatectomy and simultaneous preperitoneal hernioplasty in patients with benign prostatic hyperplasia and inguinal hernia show a decrease in the duration of surgery and intraoperative blood loss. The use of mesh prosthesis in the performance of pre-abdominal plastics of inguinal hernias and one-time supraventricular prostatectomy allows one surgical pathology to be eliminated simultaneously with one access, to prevent recurrence of hernia, to improve the quality of life of the patient and to have economic justification.