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Single-port transvesical enucleation of the prostate for benign prostatic hyperplasia with severe intravesical prostatic protrusion

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Abstract

Objectives

To introduce the surgical techniques of a single-port transvesical enucleation of the prostate (STEP) for enlarged prostates with severe intravesical prostatic protrusion (IPP) presenting with lower urinary tract symptoms (LUTS).

Patients and Methods

Our study included 7 patients with prostates larger than 80 mL and with severe IPP who underwent STEP. All the procedures were performed using a home-made single-port device through a 3-cm midline incision at the level three fingerbreadths above the symphysis pubis. Rigid laparoscopic instruments and Harmonic Scalpels® were used to enucleate the large adenoma of the prostate.

Results

All the procedures were completed satisfactorily, with no intra and early postoperative complications. The mean resected prostatic weight was 54.14 ± 8.38 g, and the mean operative time was 191.86 ± 40.88 min. The mean time for catheterization was 5.29 ± 1.80 days. The postoperative 3-month international prostate symptoms score (IPSS) and maximal flow rate (Qmax) were improved following STEP (IPSS; 23.57 ± 2.15 vs. 11.43 ± 2.44, Qmax; 17.14 ± 3.44 mL/s vs. 6.71 ± 2.29 mL/s).

Conclusions

Laparoendoscopic single-site surgery (LESS) and enucleation of the prostate with rigid laparoscopic instruments might be difficult but is feasible. STEP may be a new treatment option for use in open prostatectomies for enlarged prostates with severe IPP in carefully selected patients.

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Authors and Affiliations

  1. Department of Urology, Hanyang University College of Medicine, Seoul, Korea

    Joo Yong Lee, Hong Sang Moon, Hong Yong Choi & Seung Wook Lee

  2. Department of Urology, KEPCO Medical Foundation Hanil General Hospital, Seoul, Korea

    June Hyun Han

  3. Department of Urology, Eulji Hospital, Eulji University School of Medicine, Seoul, Korea

    Tag Keun Yoo

  4. Department of Urology, Hanyang University Guri Hospital, 249-1, Gyomun-dong, Guri, 471-701, Korea

    Seung Wook Lee

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  1. Joo Yong Lee
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  2. June Hyun Han
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Correspondence to Seung Wook Lee.

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Lee, J.Y., Han, J.H., Moon, H.S. et al. Single-port transvesical enucleation of the prostate for benign prostatic hyperplasia with severe intravesical prostatic protrusion. World J Urol 30, 511–517 (2012). https://doi.org/10.1007/s00345-011-0758-0

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  • DOI: https://doi.org/10.1007/s00345-011-0758-0

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