Open suprapubic versus retropubic prostatectomy in the treatment of benign prostatic hyperplasia during resident's learning curve: a randomized controlled trial

ABSTRACT Purpose: This study compared the suprapubic (SP) versus retropubic (RP) prostatectomy for the treatment of large prostates and evaluated perioperative surgical morbidity and improvement of urinary symptoms. Materials and Methods: In this single centre, prospective, randomised study, 65 consecutive patients with LUTS and surgical indication with prostate volume greater than 75g underwent open prostatectomy to compare the RP (32 patients) versus SP (33 patients) technique. Results: The SP group exhibited a higher incidence of complications (p=0.002). Regarding voiding pattern analysis (IPSS and flowmetry), both were significantly effective compared to pre-treatment baseline. The RP group parameters were significantly better, with higher peak urinary flow (SP: 16.77 versus RP: 23.03mL/s, p=0.008) and a trend of lower IPSS score (SP: 6.67 versus RP 4.14, p=0.06). In a subgroup evaluation of patients with prostate volumes larger than 100g, blood loss was lower in those undergoing SP prostatectomy (p=0.003). Patients with prostates smaller than 100g in the SP group exhibited a higher incidence of low grade late complications (p=0.004). Conclusions: The SP technique was related to a higher incidence of minor complications in the late postoperative period. High volume prostates were associated with increased bleeding when the RP technique was utilized. The RP prostatectomy was associated with higher peak urinary flow and a trend of a lower IPSS Score.

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Main Authors: Carneiro,Arie, Sakuramoto,Paulo, Wroclawski,Marcelo Langer, Forseto,Pedro Herminio, Julio,Alexandre Den, Bautzer,Carlos Ricardo Doi, Lins,Leonardo Monte Marques, Kataguiri,Andre, Yamada,Fernanda Batistini, Teixeira,Gabriel Kushiyama, Tobias-Machado,Marcos, Pompeo,Antonio Carlos Lima
Format: Digital revista
Language:English
Published: Sociedade Brasileira de Urologia 2016
Online Access:http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382016000200284
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spelling oai:scielo:S1677-553820160002002842016-05-19Open suprapubic versus retropubic prostatectomy in the treatment of benign prostatic hyperplasia during resident's learning curve: a randomized controlled trialCarneiro,ArieSakuramoto,PauloWroclawski,Marcelo LangerForseto,Pedro HerminioJulio,Alexandre DenBautzer,Carlos Ricardo DoiLins,Leonardo Monte MarquesKataguiri,AndreYamada,Fernanda BatistiniTeixeira,Gabriel KushiyamaTobias-Machado,MarcosPompeo,Antonio Carlos Lima Prostatic Hyperplasia Prostatectomy Postoperative Complications Prostate ABSTRACT Purpose: This study compared the suprapubic (SP) versus retropubic (RP) prostatectomy for the treatment of large prostates and evaluated perioperative surgical morbidity and improvement of urinary symptoms. Materials and Methods: In this single centre, prospective, randomised study, 65 consecutive patients with LUTS and surgical indication with prostate volume greater than 75g underwent open prostatectomy to compare the RP (32 patients) versus SP (33 patients) technique. Results: The SP group exhibited a higher incidence of complications (p=0.002). Regarding voiding pattern analysis (IPSS and flowmetry), both were significantly effective compared to pre-treatment baseline. The RP group parameters were significantly better, with higher peak urinary flow (SP: 16.77 versus RP: 23.03mL/s, p=0.008) and a trend of lower IPSS score (SP: 6.67 versus RP 4.14, p=0.06). In a subgroup evaluation of patients with prostate volumes larger than 100g, blood loss was lower in those undergoing SP prostatectomy (p=0.003). Patients with prostates smaller than 100g in the SP group exhibited a higher incidence of low grade late complications (p=0.004). Conclusions: The SP technique was related to a higher incidence of minor complications in the late postoperative period. High volume prostates were associated with increased bleeding when the RP technique was utilized. The RP prostatectomy was associated with higher peak urinary flow and a trend of a lower IPSS Score.info:eu-repo/semantics/openAccessSociedade Brasileira de UrologiaInternational braz j urol v.42 n.2 20162016-04-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382016000200284en10.1590/S1677-5538.IBJU.2014.0517
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language English
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author Carneiro,Arie
Sakuramoto,Paulo
Wroclawski,Marcelo Langer
Forseto,Pedro Herminio
Julio,Alexandre Den
Bautzer,Carlos Ricardo Doi
Lins,Leonardo Monte Marques
Kataguiri,Andre
Yamada,Fernanda Batistini
Teixeira,Gabriel Kushiyama
Tobias-Machado,Marcos
Pompeo,Antonio Carlos Lima
spellingShingle Carneiro,Arie
Sakuramoto,Paulo
Wroclawski,Marcelo Langer
Forseto,Pedro Herminio
Julio,Alexandre Den
Bautzer,Carlos Ricardo Doi
Lins,Leonardo Monte Marques
Kataguiri,Andre
Yamada,Fernanda Batistini
Teixeira,Gabriel Kushiyama
Tobias-Machado,Marcos
Pompeo,Antonio Carlos Lima
Open suprapubic versus retropubic prostatectomy in the treatment of benign prostatic hyperplasia during resident's learning curve: a randomized controlled trial
author_facet Carneiro,Arie
Sakuramoto,Paulo
Wroclawski,Marcelo Langer
Forseto,Pedro Herminio
Julio,Alexandre Den
Bautzer,Carlos Ricardo Doi
Lins,Leonardo Monte Marques
Kataguiri,Andre
Yamada,Fernanda Batistini
Teixeira,Gabriel Kushiyama
Tobias-Machado,Marcos
Pompeo,Antonio Carlos Lima
author_sort Carneiro,Arie
title Open suprapubic versus retropubic prostatectomy in the treatment of benign prostatic hyperplasia during resident's learning curve: a randomized controlled trial
title_short Open suprapubic versus retropubic prostatectomy in the treatment of benign prostatic hyperplasia during resident's learning curve: a randomized controlled trial
title_full Open suprapubic versus retropubic prostatectomy in the treatment of benign prostatic hyperplasia during resident's learning curve: a randomized controlled trial
title_fullStr Open suprapubic versus retropubic prostatectomy in the treatment of benign prostatic hyperplasia during resident's learning curve: a randomized controlled trial
title_full_unstemmed Open suprapubic versus retropubic prostatectomy in the treatment of benign prostatic hyperplasia during resident's learning curve: a randomized controlled trial
title_sort open suprapubic versus retropubic prostatectomy in the treatment of benign prostatic hyperplasia during resident's learning curve: a randomized controlled trial
description ABSTRACT Purpose: This study compared the suprapubic (SP) versus retropubic (RP) prostatectomy for the treatment of large prostates and evaluated perioperative surgical morbidity and improvement of urinary symptoms. Materials and Methods: In this single centre, prospective, randomised study, 65 consecutive patients with LUTS and surgical indication with prostate volume greater than 75g underwent open prostatectomy to compare the RP (32 patients) versus SP (33 patients) technique. Results: The SP group exhibited a higher incidence of complications (p=0.002). Regarding voiding pattern analysis (IPSS and flowmetry), both were significantly effective compared to pre-treatment baseline. The RP group parameters were significantly better, with higher peak urinary flow (SP: 16.77 versus RP: 23.03mL/s, p=0.008) and a trend of lower IPSS score (SP: 6.67 versus RP 4.14, p=0.06). In a subgroup evaluation of patients with prostate volumes larger than 100g, blood loss was lower in those undergoing SP prostatectomy (p=0.003). Patients with prostates smaller than 100g in the SP group exhibited a higher incidence of low grade late complications (p=0.004). Conclusions: The SP technique was related to a higher incidence of minor complications in the late postoperative period. High volume prostates were associated with increased bleeding when the RP technique was utilized. The RP prostatectomy was associated with higher peak urinary flow and a trend of a lower IPSS Score.
publisher Sociedade Brasileira de Urologia
publishDate 2016
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382016000200284
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