Laparoscopic adenomectomy: 10 years of experience Carpio Villanueva, J; Rosales Bordes, A; Ponce de León Roca, J ...
Actas urológicas españolas (English ed.),
04/2018, Volume:
42, Issue:
3
Journal Article
Peer reviewed
INTRODUCTIONLower urinary tract symptoms secondary to increased prostate volume are associated with ageing and are becoming more prevalent due to increased life expectancy. We present our experience ...with transperitoneal laparoscopic adenomectomy for the management of bladder outlet obstruction caused by benign prostatic enlargement. MATERIALS AND METHODSWe performed a retrospective review of patients who underwent laparoscopic adenomectomy between 2005 and 2015. We recorded age, maximum flow and postvoid residual urine (preoperative and postoperative), surgical time, operative bleeding, weight and pathology, complications and duration of catheterisation and hospitalisation. RESULTSWe included 80 patients with a mean age of 70 years. The mean preoperative and postoperative Qmax was 8.21mL/s and 22.52mL/s, respectively. The mean preoperative and postoperative postvoid residual urine was 91.4mL and 14.2mL, respectively. The mean surgical time was 137.7min. Conversion to open surgery was necessary in one case due to intestinal injury. The mean intraoperative bleeding was 227.6mL. The mean hospital stay was 5.46 days, and the catheterisation time was 4.86 days. There were 13 complications, which were recorded according to the Clavien-Dindo system, 3 of which were severe. The mean weight of the surgical specimen was 80.02g. Pathology showed benign hyperplasia in 75 cases and prostate cancer in the remaining 5. CONCLUSIONLaparoscopic adenomectomy is a safe, reproducible technique with the same functional results as open surgery. Our series shows that this approach is useful and safe and has a low rate of complications.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
2.
Laparoscopic adenomectomy: 10 years of experience Carpio Villanueva, J.; Rosales Bordes, A.; Ponce de León Roca, J. ...
Actas urológicas españolas (English ed.),
April 2018, 2018-Apr, 2018-04-00, Volume:
42, Issue:
3
Journal Article
Peer reviewed
Lower urinary tract symptoms secondary to increased prostate volume are associated with aging and are becoming more prevalent due to increased life expectancy. We present our experience with ...transperitoneal laparoscopic adenomectomy for the management of bladder outlet obstruction caused by benign prostatic enlargement.
We performed a retrospective review of patients who underwent laparoscopic adenomectomy between 2005 and 2015. We recorded age, maximum flow and postvoid residual urine (preoperative and postoperative), surgical time, operative bleeding, weight and pathology, complications and duration of catheterisation and hospitalization.
We included 80 patients with a mean age of 70 years. The mean preoperative and postoperative Qmax was 8.21mL/s and 22.52mL/s, respectively. The mean preoperative and postoperative postvoid residual urine was 91.4mL and 14.2mL, respectively. The mean surgical time was 137.7min. Conversion to open surgery was necessary in one case due to intestinal injury. The mean intraoperative bleeding was 227.6mL. The mean hospital stay was 5.46 days, and the catheterisation time was 4.86 days. There were 13 complications, which were recorded according to the Clavien-Dindo system, 3 of which were severe. The mean weight of the surgical specimen was 80.02g. Pathology showed benign hyperplasia in 75 cases and prostate cancer in the remaining 5.
Laparoscopic adenomectomy is a safe, reproducible technique with the same functional results as open surgery. Our series shows that this approach is useful and safe and has a low rate of complications.
Los síntomas del tracto urinario inferior secundarios al aumento del volumen prostático están asociados con la edad, y se están volviendo más prevalentes por el aumento de la esperanza de vida. Presentamos nuestra experiencia con la adenomectomía laparoscópica transperitoneal para el manejo de la obstrucción infravesical de origen prostático.
Se realizó una revisión retrospectiva de los pacientes sometidos a una adenomectomía laparoscópica entre 2005 y 2015. Se registró la edad, el flujo máximo y el residuo posmiccional pre y posquirúrgicos, el tiempo quirúrgico, el sangrado operatorio, el peso y la anatomía patológica, los días de sondaje y hospitalización y las complicaciones.
Se incluyeron 80 pacientes con una edad media de 70 años. El Qmáx medio prequirúrgico fue 8,21ml/s y el posterior 22,52ml/s. La media del residuo posmiccional previo fue 91,4ml y el posterior 14,2ml. El tiempo quirúrgico medio fue 137,7minutos. Fue necesaria la conversión a cirugía abierta en un caso por lesión intestinal. El sangrado intraoperatorio medio fue 227,6ml. La estancia hospitalaria media fueron 5,46 días, y el tiempo de sondaje 4,86 días. Tuvimos 13 complicaciones que se registraron según el sistema Clavien-Dindo, siendo 3 de gravedad. El peso medio de la pieza quirúrgica fue 80,02g. La anatomía patológica mostró hiperplasia benigna en 75 casos y cáncer de próstata en los 5 restantes.
La adenomectomía laparoscópica es una técnica segura, reproducible y con los mismos resultados funcionales de la cirugía abierta. Nuestra serie muestra que este abordaje es útil, seguro y con una baja tasa de complicaciones.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
To assess the effectiveness of noninvasive bladder lithiasis treatment without associated prostate surgery to know whether bladder lithiasis is an absolute indication for prostate surgery.
Fifty ...patients with bladder lithiasis were entered in a prospective trial and were treated with extracorporeal shock wave lithotripsy if lithiasis was smaller than 4 cm
2. Independent of the presence or absence of bladder outlet obstruction, in no case was prostate surgery associated. The variables studied were the effectiveness of the treatment, changes in the International Prostate Symptom Score (IPSS), and the subsequent need for desobstructive prostate surgery. The statistical study was performed using Student’s
t test and the proportional hazards model.
Bladder lithiasis was successfully eliminated in 93% of the cases (in 77% of them with a single extracorporeal shock wave lithotripsy session). The mean IPSS decreased from 17.7 to 9.7 points (
P = 0.0001) after lithiasis elimination. After a mean follow-up of 22 months, a mere 8% of the patients needed subsequent prostate surgery because their IPSS had increased to 20 points or more. The sole prognostic factor for the need for ensuing prostate surgery was the pretreatment IPSS score (
P = 0.042).
Noninvasive management of bladder lithiasis with no associated prostate surgery is highly efficient and results in marked symptomatic improvement. Furthermore, the number of patients needing subsequent prostate surgery was very low at mid-term follow-up. Because of all of the above, the existence of bladder lithiasis is not an absolute indication for prostate surgery.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Abstract Objectives To study the technical opinion of an expert panel and reach a consensus of professional criterion in relation to the most recent scientific evidence in benign prostatic ...hyperplasia (BPH) in the scopes of diagnosis, progression criteria, medical treatment and surgical treatment. Material and methods Systematized review of the literature of the last 10 years in BPH by means of a scientific committee and elaboration of a 64-question questionnaire divided into three strategic areas: (1) Diagnosis and stratification of the patients with BPH considering the progression risk factors, (2) novelties in the medical treatment and (3) new contributions in the surgical and minimally invasive treatment in BPH. A panel of 50 urologists standing out for their knowledge in BPH distributed throughout the national geographic area was chosen, establishing the Delphi methodology for the study through the application of two successive online surveys. Results The 50 experts consulted completed the two groups of the questionnaire. In the first, a consensus of criterion was observed in 50 out of the 64 questions analyzed, achieving a consensus in 59/65 (92.5%) in the second round, which included aspects of morbidity of the lower urinary tract symptoms (LUTS), diagnostic tests necessary in the initial evaluation of the specialist, stratification of the patients in relation to the risk of progression, strategies of step-by-step medical therapy and combination in patients with risk of Acute Urinary Retention (AUR) or surgery and of the indications of surgical therapy and the role of new less invasive treatments. Conclusions In a condition of the high prevalence of BPH, in which we have seen important changes in its entire spectrum in recent years, the obtaining of an elevated consensus to which a large number of reference specialists in this condition have contributed will be of great importance for the usual clinical management of this disease.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
5.
Fístula uretrocavernosa por fractura penena Juaneda Castell, B; Montlleó González, M; Ponce de León Roca, X ...
Actas urologicas españolas,
2008, Volume:
32, Issue:
10
Journal Article
Open access
Resumen La fractura de pene con laceración de la uretra se presenta con dolor y hematoma, detumescencia, fallo en la erección y uretrorragia. Describimos el tercer caso publicado en la literatura de ...fistula uretrocavernosa por fractura peneana ocurrida durante el coito.
To study the technical opinion of an expert panel and reach a consensus of professional criterion in relation to the most recent scientific evidence in Benign Prostatic Hyperplasia (BPH) in the ...scopes of diagnosis, progression criteria, medical treatment and surgical treatment.
Systematized review of the literature of the last 10 years in BPH by means of a scientific committee and elaboration of a 64-question questionnaire divided into three strategic areas: 1.- Diagnosis and stratification of the patients with BPH considering the progression risk factors. 2.-Novelties in the medical treatment and 3.- New contributions in the surgical and minimally invasive treatment in BPH. A panel of 50 urologists standing out for their knowledge in BPH distributed throughout the national geographic area was chosen, establishing the Delphi methodology for the study through the application of two successive online surveys.
The 50 experts consulted completed the two groups of the questionnaire. In the first, a consensus of criterion was observed in 50 out of the 64 questions analyzed, achieving a consensus in 59/65 (92.5%) in the second round, which included aspects of morbidity of the lower urinary tract symptoms (LUTS), diagnostic tests necessary in the initial evaluation of the specialist, stratification of the patients in relation to the risk of progression, strategies of step-by-step medical therapy and combination in patients with risk of Acute Urinary Retention (AUR) or surgery and of the indications of surgical therapy and the role of new less invasive treatments.
In a condition of the high prevalence of BPH, in which we have seen important changes in its entire spectrum in recent years, the obtaining of an elevated consensus to which a large number of reference specialists in this condition have contributed will be of great importance for the usual clinical management of this disease.
Urethrocavernous fistula due to penile fracture Juaneda Castell, B; Montlleó González, M; Ponce de León Roca, X ...
Actas urologicas españolas,
2008 Nov-Dec, 20081101, Volume:
32, Issue:
10
Journal Article
Open access
Penile fracture with urethral laceration usually presents with pain and haematoma, detumescence, erectile failure and blood loss through urethral meatus. We describe the third published case of ...urethrocavernous fistula following blunt penile trauma sustained durind sexual intercourse.
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