Comparative analysis of laparoscopic retropubic simple prostatectomy combined with provisional clamping of internal iliac arteries, urethrocystoanastomosis and transurethral resection of benign prostatic hyperplasia

Abstract

Aim. To provide comparative analysis of laparoscopic retropubic simple prostatectomy combined with provisional clamping of internal iliac arteries, uretherocystoanastomosis (LRP + CIIA + UCA) and transurethral resection of prostate (TURP) for surgical treatment benign prostatic hyperplasia (BPH).Materials and methods. 103 patients of age ³40 years old with refracted symptoms of urinary tract compression caused by BPH. The period of observation: from 2019 until the May 20, 2022; 48 and 51 patients were primary observed before and 6 months after LRP + CIIA + UCA and TURP. Criteria of inclusion: prostatic volume 60–80 cm3.Pre-operative treatment included such parameters as prostate-specific antigen level. Volume of prostate, volume of residual urine, urodynamic parameters, IPSS (International Prostate Symptom Score) + quality of life (QoL) scale result. Postoperative observation after 6 months included uroflowmetry, residual urine volume, evaluation of lower urinary tract symptoms and their influence on IPSS and QoL scale result. Efficacy of treatment of BPH is a summary of all earlier described parameters.Results. Symptomatic regression in patients who underwent LRP + CIIA + UCA and TURP was found among 15 (93.75 %) and 13 (81.25 %) patients relatively; complications distributed throughout 1, 2 and 3 classes by Clavien-Dindo criteria: after TURP – among 71.4, 22.9 and 5.7 % patients, after LPA + CIIA + UCA – among 35.4, 24.2 and 11.3 %, relatively. After 6 months maximal urine flow improved up to 22.7 ± 2.2 ml/seс, 16.8 ± 1.5 ml/seс, relatively.Conclusion. LRP + CIIA + UCA is effective for urodynamic and life quality improvement like TURP. LRP + CIIA + UCA has shown statistically significant advantages of such parameters as blood loss, bladder neck contractures and urethral strictures.