Suprapubic prostatectomy. The removable purse string: a continuing comparative analysis of 300 consecutive cases

Area of Science:

• Urology
• Surgical Procedures
• Patient Outcomes

Background:

• Benign prostatic hyperplasia (BPH) is a common condition in aging men.
• Traditional prostatectomy methods can involve significant morbidity.
• Evaluating minimally invasive or simpler surgical techniques is crucial for improving patient care.

Purpose of the Study:

• To analyze outcomes of suprapubic prostatectomy with a specific bladder neck closure technique.
• To compare the efficacy and safety of this method against existing literature.
• To advocate for broader adoption and training in this surgical approach.

Main Methods:

• Retrospective analysis of 300 patients undergoing suprapubic prostatectomy.
• Utilized a removable purse-string closure of the bladder neck.
• Compared key surgical metrics including mortality, hospitalization, transfusion needs, tissue weight, complications, and operative time.

Main Results:

• Achieved the lowest reported mortality rate for a large series of suprapubic prostatectomies.
• Demonstrated low transfusion requirements and minimal long-term complications.
• The procedure was technically simple, rapid to perform, and adaptable for combined surgeries.

Conclusions:

• Suprapubic prostatectomy with purse-string bladder neck closure is a highly desirable method for removing large benign prostates (≥40 gm).
• The technique offers significant advantages in terms of simplicity, speed, and patient outcomes.
• Broader indications and increased emphasis on training are recommended for this procedure.