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Large benign prostatic hyperplasia means impossible ureteroscopy: myth or reality?
R M Scarpa1, A De Lisa, D Porru
1Clinica Urologica e Scuola di Specializzazione in Urologia, Dipartimento di Scienze Chirurgiche e Trapianti d'Organo, Università degli Studi di Cagliari, Ospedale SS. Trinità, Cagliari, Italy.
European Urology
|April 15, 2000
Summary
Benign prostatic hypertrophy (BPH) does not impede ureteroscopy for expert surgeons. Tumors and inflammation, not enlarged prostates, are the primary obstacles during the procedure.
Area of Science:
- Urology
- Endourology
Background:
- Large prostates due to benign prostatic hypertrophy (BPH) are often cited as an impediment to ureteroscopy.
- Previous literature suggests BPH can hinder ureteroscopic procedures.
Purpose of the Study:
- To determine the actual impact of large prostates with BPH on ureteroscopy.
- To identify the most frequent obstacles encountered during ureteroscopy.
Main Methods:
- Retrospective review of 2,147 endourological reports and clinical records.
- Analysis of 54 ureteroscopies performed in patients with enlarged prostates or large median lobes.
Main Results:
- No instances were reported where an enlarged prostate hindered ureteroscopy.
- The primary causes of ureteroscopy impediment were tumors (uterine, ovarian, ureteral, bowel, bladder, prostate) and inflammation.
Conclusions:
- Benign prostatic hypertrophy (BPH) does not inherently impede ureteroscopy when performed by experienced operators with appropriate instruments.
- Tumors and severe inflammation/infection are significant obstacles, potentially requiring complex maneuvers.
- BPH causes displacement rather than infiltration, allowing for technical compensation.