ABSTRACT
Purpose: To compare the functional effects and complicationsof transvesical prostatectomy (TVP) and bipolar transurethralresection of prostate (TURP) in patients with benign prostatichyperplasia (BPH) more than 100 gms.Method: Hundred and five patients participated at the SPMCMedical College, Bikaner, India with complaints of BPH withprostate size of 100-150 gm over study duration from June2015 to May 2018. Patients were grouped according to theireligibility for the two surgical procedures namely TVP (n=56)and bipolar TURP (n=49).Results: Of the total 105 patients, 56 (53.33%) patients weresurgically treated with TVP while the remaining 49 (46.67%)were managed with TURP. We did not observe any statisticallysignificant difference between the two groups with regards theIPSS, Qmax, residual urine volume. The numbers of postoperative complications were higher in TURP group (n=9) ascompared to TVP (n=3). Even the late complications such asstricture formation, need for redoing the surgery were higher inTURP group compared to TVP group.Conclusion: Open prostatectomy is a safer and more effectivesurgical treatment option for patients with BPH more than 100gms as compared to bipolar TURP. Even the reports of postoperative complications were higher in TURP group.
ABSTRACT
Objective To assess the clinical efficacy and safety of transurethral plasmakinetic enucleation of prostate (PKEP) and suprapubic transvesical prostatectomy (SPP) in the treatment of large volume benign prostatic hyperplasia (BPH).Methods A total of eighty patients with large volume BPH were selected in the First People''s Hospital of Xuzhou from March 2014 to December 2016,and they were randomly divided into two groups,the PKEP group and SPP group,with 40 cases in each group.The comparison was made between the two groups in terms of operation indicators,postoperative complications followed up for 6 months after surgery and other related curative effect indexes.Results In the SPP group,the intraoperative blood loss was significantly higher than that of the PKEP group ((215.7±10.4) ml vs.(75.6±9.2) ml,t=6.541,P0.05).But the catheterization time after operation,bladder irrigation time and length of hospital stay were significantly longer in the PKEP group than in the SPP group ((6.3±1.8) d vs.(2.4±0.6) d,(5.5±1.4) d vs.(1.3±0.6) d,(7.7±2.3) d vs.(3.1±0.7) d,t=4.357,2.542,2.975,P0.05).The rate of complication occurrence in the PKEP group were lower than that of the SPP group (P<0.05).Conclusion PKEP was effective in the treatment of BPH,with less bleeding loss,fewer complications and quick recovery.It can significantly improve the life quality of the patients and will be an ideal treatment for large volume BPH.
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Objective To summarize the diagnosis,treatment and prevention of dysuria within 6 months after the suprapubic transvesical prostatectomy. Methods Twenty-four cases were retrospectively reviewed,including the data on the diagnosis, treatment and prognosis. Results Twenty-one of the 24 cases had received surgery. There were 9 cases with bladder neck stricture,9 cases with posterior urethra stricture and 3 cases with of remnant glands. Nine cases received transurethral bladder neck incision, 9 received open surgery ( bladder neck,posterior urethral incision) and 3 received transurethral resection of the prostate (TURP) plus bladder neck incision. The other 3 diagnosed as detrusor weakness were conservatively treated by indwelling catheter and they were improved one months later. None of these patients was readmitted into hospital for dysuria within 6 months after treatment. Conclusion The recurrence of dysuria post prostatectomy mostly ( 75% ) occurred within 6 months after surgery. A majority of these patients need a second surgery. To avoid a second surgery for postoperative dysuria, much attention should be paid to the operating technique and postoperative management.
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Introdução e objetivos: Prostatectomia transvesical (PTV) é uma operação simples e fácil de ser realizada. Sua principal indicação é no grande adenoma prostático associado ou não à patologia vesical. Realizamos algumas modificações técnicas que permitiram um maior controle do sangramento, alta hospitalar no terceiro dia de pós-operatório e sem sonda vesical. Material e métodos: Entre 2001 e 2005, 102 pacientes com grandes adenomas prostáticos foram submetidos à prostatectomia transvesical suprapúbica modificada pelo mesmo cirurgião. A idade média dos pacientes foi 67,8 anos (59 a 82 anos). O peso médio do adenoma foi 81,5g. A abertura da bexiga na sua região fúndica é pequena o suficiente para passar dois ou três dedos ou um espéculo vaginal tamanho médio. A bexiga é fechada por uma sutura contínua. O fio de categute, por não ultrapassar as camadas da bexiga, evita a comunicação da luz vesical com o espaço de retzius, favorecendo a cicatrização rápida da mucosa vesical. Hemostasia mais eficaz foi obtida com a realização de pontos em ?X? pegando parte da cápsula a partir do colo vesical e aplicados às 3, 5, 7 e 9 horas. Resultados: As modificações descritas permitiram a retirada da sonda no terceiro dia de pós-operatório. Não houve aumento das complicações. Foi diminuído o custo hospitalar e amenizado o sofrimento do paciente com o menor tempo de uso da sonda. Conclusões: A seleção adequada do paciente associada às modificações técnicas adotadas resolveram os dois maiores problemas da PTV: maior tempo de internação e uso da sonda vesical.
ABSTRACT
The purpose of this study was to test the effects of perineal exercises on ability to control urination; i.e., continence of urine in patients undergoing suprapubic transvesical prostatectomy or transurethral prostatectomy. The study was conducted in surgical ward Mahidol Bampen 2, Siriraj Hospital. The quasi-experimental design was used as the method of procedure. The 30 subjects were equally assigned into one control and one experimental group. The experimental group patients received an extra treatment; i.e., systemically organized nursing instructions on period exercises for both pre and post operative phases. The control group patients received no extra treatment, only what was routinely provided in the ward. A Patient Continence Status Checklist (PCSC) was specially designed for this study. It uses a nominal scale to evaluate patients at their first voiding after the removal of urethral catheter or suprapubic cystostomy tube. It was found that the number of continent patients were significantly higher in the experimental group than in the control group (p<.01). This indicated that the experimental group patients showed higher ability to control urination than the control group patients.