Modified laparoscopic simple prostatectomy combined with temporary internal iliac arteries clamping and urethrocystoanastomosis for large-volume benign prostatic hyperplasia: evaluation of efficacy and safety
Introduction. Laparoscopic simple prostatectomy is the method of choice for surgical treatment of large-volume benign prostatic hyperplasia (BPH). However, the existing limitations of standard approaches are the reason for the development of new modifications.Objective. To evaluate the efficacy and...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | Russian |
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State Budget Educational Institute of Higher Professional Education, Rostov State Medical University, Ministry Health of Russian Federation
2023-12-01
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| Series: | Vestnik Urologii |
| Subjects: | |
| Online Access: | https://www.urovest.ru/jour/article/view/788 |
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| author | S. N. Volkov D. Yu. Pushkar K. B. Kolontarev V. S. Stepanchenko V. I. Tereshchenko A. R. Dzharimok E. N. Andreeva O. R. Grigoryan A. E. Shevyakina M. A. Daurov |
| author_facet | S. N. Volkov D. Yu. Pushkar K. B. Kolontarev V. S. Stepanchenko V. I. Tereshchenko A. R. Dzharimok E. N. Andreeva O. R. Grigoryan A. E. Shevyakina M. A. Daurov |
| author_sort | S. N. Volkov |
| collection | DOAJ |
| description | Introduction. Laparoscopic simple prostatectomy is the method of choice for surgical treatment of large-volume benign prostatic hyperplasia (BPH). However, the existing limitations of standard approaches are the reason for the development of new modifications.Objective. To evaluate the efficacy and safety of a modified laparoscopic simple prostatectomy (LSP), supplemented by temporary internal iliac arteries (IIA) clamping and vesicourethral anastomosis (VUA).Materials & methods. This multicenter open study included 195 patients (mean age 68.1 ± 6.4 years) who underwent LSP combined with temporary IIA clamping and VUA. The primary efficacy criterias during one follow-up year were the severity of urinary symptoms (IPSS), quality of life, maximum flow rate and post-void residual volume. All complications that developed during the 12-month postoperative follow-up period were registered. Statistical calculations were performed using IBM SPSS 23.2 software.Results. The average surgery time was 91.5 ± 23.2 minutes. Complications of Clavien-Dindo I, II, III grades were noted in 1.0%, 1.0% and 3.6% of patients, respectively; no complications of group IV developed. The mean bed-days were 5.2 ± 1.5 days, the decrease in hemoglobin was 0.6 ± 1.1 g/dL. No patient needed to use an irrigation system. Based on the results of 12 months postoperative follow-up, positive dynamics was established for average IPSS score (p = 0.003), QoL (p = 0.035), maximum urine flow rate (p = 0.012), residual urine volume (p = 0.004). The maximum urine flow rate one year after surgery reached 24.6 ± 2.8 ml/s, the post-void residual urine volume was 15.1 ± 11.9 ml, the average IPSS score was 9.1 ± 1.5, and the QoL score – 1.0 ± 0.7. During the 12-month follow-up period, a low amount of long-term complications was noted in 4 (2.1%) cases: 3 (1.6%) patients had stress urinary incontinence, 1 (0.5%) patient had bladder neck contracture.Conclusion. Modified LSP combined with temporary IIA clamping and VUA is associated with favorable efficacy and safety profile of the intervention in patients with large-volume BPH. |
| first_indexed | 2024-03-07T14:23:49Z |
| format | Article |
| id | doaj.art-f98a341813b642c9a1d1549a897d9f9d |
| institution | Directory Open Access Journal |
| issn | 2308-6424 |
| language | Russian |
| last_indexed | 2024-03-07T14:23:49Z |
| publishDate | 2023-12-01 |
| publisher | State Budget Educational Institute of Higher Professional Education, Rostov State Medical University, Ministry Health of Russian Federation |
| record_format | Article |
| series | Vestnik Urologii |
| spelling | doaj.art-f98a341813b642c9a1d1549a897d9f9d2024-03-06T08:56:06ZrusState Budget Educational Institute of Higher Professional Education, Rostov State Medical University, Ministry Health of Russian FederationVestnik Urologii2308-64242023-12-01114162610.21886/2308-6424-2023-11-4-16-26480Modified laparoscopic simple prostatectomy combined with temporary internal iliac arteries clamping and urethrocystoanastomosis for large-volume benign prostatic hyperplasia: evaluation of efficacy and safetyS. N. Volkov0D. Yu. Pushkar1K. B. Kolontarev2V. S. Stepanchenko3V. I. Tereshchenko4A. R. Dzharimok5E. N. Andreeva6O. R. Grigoryan7A. E. Shevyakina8M. A. Daurov9National Medical Research Center for EndocrinologyYevdokimov Moscow State University of Medicine and DentistryYevdokimov Moscow State University of Medicine and DentistryNational Medical Research Center for EndocrinologyNational Medical Research Center for EndocrinologyAdygea Republican Clinical HospitalNational Medical Research Center for EndocrinologyNational Medical Research Center for EndocrinologyNational Medical Research Center for EndocrinologyAdygea Republican Clinical HospitalIntroduction. Laparoscopic simple prostatectomy is the method of choice for surgical treatment of large-volume benign prostatic hyperplasia (BPH). However, the existing limitations of standard approaches are the reason for the development of new modifications.Objective. To evaluate the efficacy and safety of a modified laparoscopic simple prostatectomy (LSP), supplemented by temporary internal iliac arteries (IIA) clamping and vesicourethral anastomosis (VUA).Materials & methods. This multicenter open study included 195 patients (mean age 68.1 ± 6.4 years) who underwent LSP combined with temporary IIA clamping and VUA. The primary efficacy criterias during one follow-up year were the severity of urinary symptoms (IPSS), quality of life, maximum flow rate and post-void residual volume. All complications that developed during the 12-month postoperative follow-up period were registered. Statistical calculations were performed using IBM SPSS 23.2 software.Results. The average surgery time was 91.5 ± 23.2 minutes. Complications of Clavien-Dindo I, II, III grades were noted in 1.0%, 1.0% and 3.6% of patients, respectively; no complications of group IV developed. The mean bed-days were 5.2 ± 1.5 days, the decrease in hemoglobin was 0.6 ± 1.1 g/dL. No patient needed to use an irrigation system. Based on the results of 12 months postoperative follow-up, positive dynamics was established for average IPSS score (p = 0.003), QoL (p = 0.035), maximum urine flow rate (p = 0.012), residual urine volume (p = 0.004). The maximum urine flow rate one year after surgery reached 24.6 ± 2.8 ml/s, the post-void residual urine volume was 15.1 ± 11.9 ml, the average IPSS score was 9.1 ± 1.5, and the QoL score – 1.0 ± 0.7. During the 12-month follow-up period, a low amount of long-term complications was noted in 4 (2.1%) cases: 3 (1.6%) patients had stress urinary incontinence, 1 (0.5%) patient had bladder neck contracture.Conclusion. Modified LSP combined with temporary IIA clamping and VUA is associated with favorable efficacy and safety profile of the intervention in patients with large-volume BPH.https://www.urovest.ru/jour/article/view/788benign prostatic hyperplasiabphlaparoscopic simple prostatectomy |
| spellingShingle | S. N. Volkov D. Yu. Pushkar K. B. Kolontarev V. S. Stepanchenko V. I. Tereshchenko A. R. Dzharimok E. N. Andreeva O. R. Grigoryan A. E. Shevyakina M. A. Daurov Modified laparoscopic simple prostatectomy combined with temporary internal iliac arteries clamping and urethrocystoanastomosis for large-volume benign prostatic hyperplasia: evaluation of efficacy and safety Vestnik Urologii benign prostatic hyperplasia bph laparoscopic simple prostatectomy |
| title | Modified laparoscopic simple prostatectomy combined with temporary internal iliac arteries clamping and urethrocystoanastomosis for large-volume benign prostatic hyperplasia: evaluation of efficacy and safety |
| title_full | Modified laparoscopic simple prostatectomy combined with temporary internal iliac arteries clamping and urethrocystoanastomosis for large-volume benign prostatic hyperplasia: evaluation of efficacy and safety |
| title_fullStr | Modified laparoscopic simple prostatectomy combined with temporary internal iliac arteries clamping and urethrocystoanastomosis for large-volume benign prostatic hyperplasia: evaluation of efficacy and safety |
| title_full_unstemmed | Modified laparoscopic simple prostatectomy combined with temporary internal iliac arteries clamping and urethrocystoanastomosis for large-volume benign prostatic hyperplasia: evaluation of efficacy and safety |
| title_short | Modified laparoscopic simple prostatectomy combined with temporary internal iliac arteries clamping and urethrocystoanastomosis for large-volume benign prostatic hyperplasia: evaluation of efficacy and safety |
| title_sort | modified laparoscopic simple prostatectomy combined with temporary internal iliac arteries clamping and urethrocystoanastomosis for large volume benign prostatic hyperplasia evaluation of efficacy and safety |
| topic | benign prostatic hyperplasia bph laparoscopic simple prostatectomy |
| url | https://www.urovest.ru/jour/article/view/788 |
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