Open surgery in huge volume benign prostatic hyperplasia

摘要

  The aim of this study is to evaluate the efficacy and safety of open surgical treatment for huge volume (& 150 ml) benign prostatic hyperplasia and summarize our clinical experiences. Between January 2001 and September 2010, surgeries for a total of 15 patients with huge volume benign prostatic hyperplasia were performed. Mean age of these patients was 71.8 ± 6.1 years. Mean prostate volume was 217.2 ± 90.6 ml (range: 150.1 to 471.7 ml). Follow-up was conducted one, three, six, and twelve months after the operation. The evaluation indicators included the maximum urinary flow rate (Qmax), international prostate symptom score (IPSS), and quality of life (QoL). Results obtained are as follows: The mean weight of the surgically removed glands was 201.3 ± 87.5 g; the mean operation time was 65 ± 20.4 min; the mean hemoglobin loss during the operation was 1.4 ± 1.3 g/dl. One case of blood transfusion was observed. After catheter removal, all of the patients could urinate on their own. One month after surgery, the Qmax increased to 21.5 ± 4.6 ml/s (P & 0.001), and the IPSS and QoL decreased to 7.3 ± 2.5 and 2.4 ± 0.3 (P & 0.05), respectively. All the patients with lower urinary tract symptoms significantly improved during the 12-month follow-up period. Two patients had mild incontinence after the operations; however, their symptoms disappeared after three months. It is concluded that open suprapubic transvesical prostatectomy is a safe and effective treatment for patients with huge volume benign prostatic hyperplasia. Sufficient preoperative preparation is important for patient safety and reducing postoperative complications.