The clinical application of combination suprapubic prostatectomy with transurethral resection of the prostate (TURP) in patients with large volume benign prostatic hyperplasia (BPH)

Abstract

Objective:

To investigate the safety and efficacy of the combination of suprapubic prostatectomy with transurethral resection of the prostate (TURP) for the treatment of large volume benign prostatic hyperplasia (BPH).

Methods:

We retrospectively analyzed the clinical data of two methods of treatment with 60 cases of a large volume BPH (>100 g) from January 2011 to 2017; the methods were suprapubic prostatectomy and suprapubic prostatectomy combination with TURP, in which the single open group comprised 30 cases, treated using the former method, and the combined open group comprised the other 30 cases, treated using the latter method. In the combined open group, the residual prostate gland was removed by TURP. We compared both the groups of patients using age, prostate volume, international prostate symptom score (IPSS), prostate-specific antigen (PSA), maximum flow rate, residual urine, operation time, hospitalization time, postoperative washing time, blood transfusion rate, and decreased amount of intraoperative hemoglobin in operation, and compared the preoperative and postoperative IPSS, maximum flow rate, and residual urine volume.

Results:

There was no significant difference between the two groups in age, prostate volume, IPSS, PSA, maximum flow rate, residual urine, and other clinical data (P > 0.05); the single group operation time, postoperative bladder irrigation time, hospitalization time, blood transfusion rate, and decreased amount of intraoperative hemoglobin were significantly greater in the single open group than in the combined open group, and statistically significant differences were observed between both the groups (P < 0.05). Postoperative voiding function improved significantly compared with the preoperative, and a statistically significant difference was observed (P < 0.05).

Conclusion:

The combination of suprapubic prostatectomy with TURP is an effective and a safe surgical method for the treatment of patients with large volume BPH. It is certainly worthy of clinical application.

Keywords

Prostatectomy BPH TURP

Get full access to this article

View all access options for this article.

References

Tubaro

de Nunzio

The current role of open surgery in BPH. EAU-EBU Update Ser 2006; 4: 191–201.

Ahmed Gadam

Nuhu

Aliyu

. Ten-year experience with open prostatectomy in Maiduguri. ISRN Urol 2012; 2012: 406872.

Malde

Nambiar

Umbach

, et al. Systematic review of the performance of noninvasive tests in diagnosing bladder outlet obstruction in men with lower urinary tract symptoms. Eur Urol 2017; 71(3): 391–402.

AUA Practice Guidelines Committee. AUA guideline on management of benign prostatic hyperplasia. Chapter 1: diagnosis and treatment recommendations. J Urol 2003; 170: 530–547.

Han

Partin

. Chapter 94. Retropubic and suprapubic open prostatectomy. In: Wein

Kavoussi

Novick

AC.

, et al. (eds) Campbell-Walsh urology. 10th ed. Philadelphia, PA: Elsevier, 2012, pp. 2695–2703.

Cockett

ATK

Aso

Chatelain

, et al. Proceedings of the international consultation on benign prostatic hyperplasia. Paris: SCI Ltd, 1991.

Simforoosh

Abdi

Kashi

, et al. Open prostatectomy versus transurethral resection of the prostate, where are we standing in the new era? A randomized controlled trial. Urol J 2010; 7(4): 262–269.

Jones

Alzweri

Rai

, et al. Holmium laser enucleation versus simple prostatectomy for treating large prostates: results of a systematic review and meta-analysis. Arab J Urol 2016; 14(1): 50–58.

Nanninga

O’Conor

Suprapubic prostatectomy: a 28 year review, 1942–1970. Int Urol Nephrol 1972; 4(4): 377–382.

10.

Moslemi

Abedin Zadeh

A modified technique of simple suprapubic prostatectomy: no bladder drainage and no bladder neck or hemostatic sutures. Urol J 2010; 7: 51–55.

11.

Qiu

Hou

, et al. Endoscopic enucleation versus open prostatectomy for treating large benign prostatic hyperplasia: a meta-analysis of randomized controlled trials. PLoS ONE 2015; 10(3): e0121265.

12.

Oranusi

Nwofor

Oranusi

IO.

Complication rates of open transvesical prostatectomy according to the Clavien-Dindo classification system. Niger J Clin Pract 2012; 15(1): 34–37.

13.

You

Tang

, et al. A randomized trial of transvesical prostatectomy versus transurethral resection of the prostate for prostate greater than 80mL. Urology 2010; 76: 958–961.

14.

Varkarakis

Kyriakakis

Delis

, et al. Long-term results of open transvesical prostatectomy from a contemporary series of patients. Urology 2004; 64: 306–310.

15.

Kuntz

Lehrich

Transurethral holmium laser enucleation versus transvesical open enucleation for prostate adenoma greater than 100 gm: a randomized prospective trial of 120 patients. J Urol 2002; 168(4 Pt 1): 1465–1469.

16.

Gilling

Fraundorfer

MR.

Holmium laser prostatectomy: a technique in evolution. Curr Opin Urol 1998; 8: 11–15.

17.

Moody

Lingeman

JE.

Holmium laser enucleation for prostate adenoma greater than 100 gm: comparison to open prostatectomy. J Urol 2001; 165(2): 459–462.

18.

Coskuner

Ozkan

Koprulu

, et al. The role of the bipolar plasmakinetic TURP over 100 g prostate in the elderly patients. Int Urol Nephrol 2014; 46: 2071–2077.

19.

Serretta

Morgia

Fondacaro

, et al. Open prostatectomy for benign prostatic enlargement in southern Europe in the late 1990s: a contemporary series of 1800 interventions. Urology 2002; 60(4): 623–627.