Comparison of the rate of complications after TUEB and cystic prostatectomy in patients with benign prostatic hyperplasia
DOI:
https://doi.org/10.14739/2310-1210.2013.4.16861Keywords:
benign prostatic hyperplasia (BPH), prostate, Transurethral Enucleation of Prostate, prostatectomyAbstract
Topicality. The most common disease of the men’s urogenital system is Benign Prostatic Hyperplasia. Causation of disease - not fully understood. There are several theories of emergence benign prostatic hyperplasia, major importance given to age-related disorders of hormonal metabolism. According to the World Health Organization (WHO) information BPH is found in 11.3% in men aged 40-49 years, and in 81,4% at the age of 80 years.
Currently, the main treatment of benign prostatic hyperplasia is operational. Each method of surgical treatment of BPH has its indications and contraindications. The indications for open prostatectomy is the presence of bladder stones, bladder tumors and bladder diverticulum, a large volume of a gland (80 cm3 or more).
Endoscopic intervention (without opening of the bladder) is performed if there is a serious general comorbidities, which does not allow to carry out major surgery if prostate volume does not exceed 80 cubic centimeters. It can be done in a relatively young age and if patient has desirability of sexual function preserving.
Postoperative results of treatment of patients in both groups, overall survival, duration of the postoperative period, the number of postoperative complications and rehabilitation of patients in the postoperative period are based on the method of surgical treatment.
The aim of our research was to make a comparative analysis of the effectiveness of transurethral resection of the prostate (TURP) and open prostatectomy in patients with BPH.
Matherials and methods: The work is based on a retrospective analysis of medical records and experience in the treatment of 40 patients with BPH (mean age - 67 ± 2,4 years), that in the period of 2012 were performed surgical treatment: 20 patients - transurethral resection (TUR) and 20 patients - open prostatectomy (20).
Results and Discussion.
It was found that each method has its advantages. So at the TURP bleeding was less. It was diagnosed in 1%, while in open prostatectomy - in 5%, infectious and inflammatory complications in 4% and 6% respectively, exacerbation of pyelonephritis in 1% and 3%of patients respectively, irritative symptoms persisted - in 2% and 3% respectively. The positive side is less operative time (30-40 min at TUR and 60-70 min at open prostatectomy), shorter periods of hospitalization (with TURP in average 5-6 days, and with open prostatectomy 60-70 days).
Negative sides which are often observed in TURP are urethra and sphincter injury during TURP (3% of patients, and open prostatectomy only in 1%), acute urinary retention (5% of patients, and in open prostatectomy - 1%) or incontinence (in 5% of patients, while after open prostatectomy in 3%).
Conclusions.
Transurethral resection of the prostate is not as effective as the open operation, significantly expanded the indications for surgical treatment, not only is the standard for small and large sizes and BPH, less dangerous than open prostatectomy and gives less complications, reduces the duration of stay of patients in hospital.
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