Is an adjustment by transurethral surgery simultaneously needed during the suprapubic open prostatectomy?

Area of Science:

• Urology
• Surgical Innovation
• Benign Prostatic Hyperplasia (BPH) Management

Background:

• Benign Prostatic Hyperplasia (BPH) is a common condition in aging men, often requiring surgical intervention for large prostates.
• Suprapubic open prostatectomy (SOP) is a traditional surgical approach for BPH.
• Managing large prostates (>100g) presents surgical challenges, including operative time and blood loss.

Purpose of the Study:

• To compare the efficacy and safety of standard suprapubic open prostatectomy (SOP) with a novel technique, SOP with transurethral adjustment of residual adenoma and bleeding (TURARAB).
• To evaluate the impact of TURARAB on operative time, perioperative bleeding, and postoperative outcomes in patients with large prostates.

Main Methods:

• A prospective study involving 49 patients with symptomatic BPH (>100g) divided into two groups: SOP (Group I) and SOP with TURARAB (Group II).
• Preoperative assessments included blood tests, International Prostate Symptom Scores, and uroflowmetry.
• TURARAB involved additional transurethral resection for residual adenoma and bleeding control after SOP enucleation.

Main Results:

• No significant baseline differences were observed between the SOP and SOP with TURARAB groups.
• Group II (SOP with TURARAB) demonstrated a shorter operative time compared to Group I (SOP).
• Significant reduction in perioperative bleeding and unnecessary blood transfusions was noted in Group II, with significant improvement in voiding function for both groups.

Conclusions:

• The novel SOP with TURARAB procedure is an effective and safe surgical option for managing large prostate glands.
• TURARAB offers advantages in reducing operative time, minimizing bleeding, and potentially lowering complications.
• This technique represents a valuable advancement in BPH surgical treatment for complex cases.