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Surgical Treatment for Benign Prostatic Hyperplasia: Holmium Laser Enucleation of the Prostate HoLEP.
Published on: March 6, 2018
Laparoscopic simple prostatectomy with prostatic urethra preservation for benign prostatic hyperplasia.
Nianzeng Xing1, Yinglu Guo1, Feiya Yang1
11 Department of Urology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China ; 2 Department of Urology, Peking University First Hospital, and Institute of Urology, Peking University, National Research Center for Urological Cancer, Beijing 100034, China.
This study introduces a new laparoscopic technique for benign prostatic hyperplasia (BPH) that preserves the prostatic urethra. The novel approach demonstrates feasibility, reduces complications, and maintains sexual function in patients with large prostates.
Area of Science:
- Urology
- Minimally Invasive Surgery
- Surgical Techniques
Background:
- Benign prostatic hyperplasia (BPH) is a common condition in aging men, often requiring surgical intervention for large prostates.
- Laparoscopic simple prostatectomy (LSP) is an alternative to open surgery, but techniques for large glands are evolving.
- Preserving the prostatic urethra during LSP is crucial for maintaining postoperative function.
Purpose of the Study:
- To describe and evaluate a novel technique for laparoscopic simple prostatectomy (LSP) that incorporates prostatic urethra preservation.
- To assess the feasibility, reproducibility, and outcomes of this technique in patients with symptomatic BPH and large prostates.
Main Methods:
- A cohort of 51 patients with symptomatic BPH underwent LSP with prostatic urethra preservation between January 2006 and September 2009.
- The technique involved specific steps including balloon dilation, trocar placement, capsular incision, subcapsular plane development, adenoma removal, and capsule suturing.
- Perioperative and outcome data, including symptom scores, flow rates, and sexual function, were collected.
Main Results:
- The mean operative time was 126 minutes with an estimated blood loss of 232 mL.
- Patients showed significant improvements in International Prostate Symptom Score (IPSS), quality of life (QOL), and maximum flow rate (Qmax) at three months post-surgery.
- No cases of urinary incontinence were reported, and sexual function (IIEF-5) and antegrade ejaculation were preserved.
Conclusions:
- Laparoscopic simple prostatectomy with prostatic urethra preservation is a feasible and reproducible surgical option for benign prostatic hyperplasia.
- This technique effectively reduces postoperative morbidity.
- Antegrade ejaculation is preserved, contributing to improved patient outcomes and quality of life.
