Prospective study comparing laparoscopic and open adenomectomy: Surgical and functional results

Area of Science:

• Urology
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Open adenomectomy (OA) is standard for large benign prostatic hyperplasia (BPH).
• Laparoscopic adenomectomy (LA) offers a minimally invasive approach.
• This study compares long-term outcomes of OA versus LA for BPH.

Purpose of the Study:

• To compare the safety and efficacy of laparoscopic adenomectomy (LA) versus open adenomectomy (OA).
• To evaluate perioperative data, functional results, and complications in a prospective study.
• To assess long-term outcomes for patients with large-volume BPH.

Main Methods:

• Prospective study of 199 patients with BPH and prostate volumes >80g.
• Patients underwent either OA (n=97) or LA (n=102).
• Comparison of demographic, perioperative, functional, and complication data.

Main Results:

• LA group had longer surgical and catheter times (P<.0001, P<.0002).
• LA group showed significantly lower operative bleeding (P<.0001), transfusion rates (P=.0015), and hospital stays (P<.0001).
• LA group had lower overall complication rates (P=.04) but similar major and late complication rates compared to OA.

Conclusions:

• Laparoscopic adenomectomy (LA) is a safe and effective alternative to open adenomectomy (OA) for large BPH.
• LA offers advantages including less bleeding, fewer transfusions, shorter hospital stays, and lower morbidity.
• Functional outcomes are comparable between LA and OA, despite longer surgical and catheter times with LA.