Laparoscopic transvesical adenomectomy for large and giant prostate gland clinical study

Introduction. Benign prostatic hyperplasia (BPH) is one of the most common diseases among elderly and senile men. Currently the effective LUTS severity decrease due to the widespread alpha-blockers usage leads to the increasing numbers of patients with large (more than 80 cm3) and giant (more than 150 cm3) prostates glands at the moment of surgery. This forces urologists to search the optimal surgery methods to treat those patients. Aim of the study. To evaluate the effectiveness of laparoscopic transvesical adenomectomy in patients with prostatic hyperplasia of large and giant sizes. Material and methods. We included 29 patients to the study. The inclusion criteria were the presence of prostatic hyperplasia and indications for surgical treatment. The median prostate volume was 185,88±20,15 cm3. The laparoscopic transvesical adenomectomy was peformed in all cases. Results. A decrease of IPSS and QoL scores and volume of residual urine, as well as an increase of Qmax, a volume of micturitions and the intervals between them were registered in all patients after surgery. Four (13,7%) patients had early postoperative complications. There were no conversions to open surgery and there were no deaths. Conclusion. Laparoscopic transvesical adenomectomy seems to be a promising method of surgical treatment of patients with large and giant prostates due to the effective correction of bladder outlet obstruction, the possibility of preventing hemorrhagic, obstructive complications, incontinence, reducing the postoperative length of stay, as well as improving the quality of life of patients in the postoperative period.