METHOD OF TRIGONIZATION (LOWERING) OF THE NECK OF THE BLADDER INTO THE PROSTATE BED WHEN PERFORMING LAPAROSCOPIC VALUED PROSTATECTOMY IN PATIENTS WITH BENIGN PROSTATIC HYPERPLASIA

Abstract

For the prevention of stricture of the bladder neck during laparoscopic prostatectomy, faster epithelialization of the prostate bed, trigonization (lowering) of the lower semicircle of the urethral neck into the prostate bed with knotted sutures is used, which remain in the lumen of the bed and can cause infl ammatory processes in it with the formation of calculi.The purpose of the study: to present a method of trigonization of the lower semicircle of the bladder neck during laparoscopic extraperitoneal pubic (transcapsular) prostatectomy in patients with benign prostatic hyperplasia.Material and methods. In the center of plastic, reconstructive and minimally invasive oncourology of the Cherkasy regional oncological dispensary and the urological department of the Vinnytsia regional hospital named after Pirogov in 2021-2023, 55 laparoscopic extraperitoneal retropubic prostatectomies were performed in patients with benign prostatic hyperplasia. In 3 patients with large lateral and middle parts of the prostate, a large bed of the prostate with a bladder neck of a small diameter (up to 1 cm) was formed. To prevent the formation of a stricture of the bladder neck and to speed up the regeneration of the prostate bed, the trigonization of the bladder neck in the prostate bed was performed by placing two P-like vicryl sutures on the lower semicircle of the bladder neck with sutures on the lateral surfaces of the prostate capsule and tying the ends of the ligatures.The results. The method made it possible to perform trigonization of the bladder neck without leaving ligatures and their ends in the lumen of the prostate bed and infl ammatory processes in it.Conclusion. The method is recommended for use in the practical work of urologists when performing onemoment laparoscopic retropubic prostatectomy in patients with benign prostatic hyperplasia with a large middle part of the prostate.