Technical aspects of extraperitoneoscopic adenomectomy in patients with large volume benign prostatic hyperplasia

Kachmazov A.A., Keshishev N.G., Gurbanov Sh.Sh., Kovchenko G.A., Osipov O.V., Grigor'eva M.V., Kazachenko A.V., Sivkov A.V., Alekseev B.Ya.

Due to implementation of minimally invasive techologies (laparoscopic surgery, Da vinci roobot) over the last 10 years, there are several publications for the nuances and effectiveness of extraperitoneoscopic adenomectomy (EA) in patients with large volume (>80 cm3) benign prostatic hyperplasia (BPH). e analysis of scientific literature showed that EA becomes more entrenched among urologists, however, resulting from lack of data for long-term treatment outcomes and a retrospective format of studies, this surgery is still being investigated (level of evidence 2).

We have reported our own experience of the EA use in 6 patients with large volume BPH. We have found a statistically significant (p<0,05) decrease in median IPSS sum to 9,5 (8:11), an increase in median Qmax to 22,5 ml/s (21:24) and a decrease in residual urine volume to 0 ml.

We have reported the technical aspects of EA with a detailed description of the methodology of this surgery.

EA is a minimally invasive surgery, that has a good cosmetic effect, however further large-scale comparison studies of effectiveness, costs and a learning curve of EA, open adenomectomy and endoscopic enucleation methods are needed for an objective evaluation of EA effectiveness.

Authors declare lack of the possible conflicts of interests.

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benign prostatic hyperplasia, extraperitoneoscopic adenomectomy