Comparative analysis of clinical results of benign prostatic hyperplasia treatment with various surgical methods

Bychkovskih Vladimir Anatol'evich, Vasil'kov Aleksandr YUr'evich, Orlov Vadim Anatol'evich, Milyutin Aleksej Aleksandrovich, ZHeleznyakov Bogdan Aleksandrovich

the results of treatment of benign prostatic hyperplasia (BPH) with new and traditional surgical methods were studied in the urology Department of the Road clinical hospital at the station «Chelyabinsk» of JSC «Russian Railways». The main groups were patients operated with new methods of bipolar transurethral resection (BTUR – 38 people) and prostate enucleation (TUEB – 35). For comparison, we selected statistically comparable groups of patients operated by the methods of monopolar transurethral resection (MTUR – 39 patients) and open transvesical prostatectomy (OPE – 37), which were used in the Department earlier before the introduction of new methods. The choice of the surgical method was determined by the volume of BPH - up to 80 cm3 used BTUR (previously MTUR), over 80 cm3 - TUEB (previously OPE). The results of TUEB vs OPE has 2-3 fold reduction in volume of blood loss during surgery, duration of postoperative bladder catheterization, frequency of intraoperative, early hemorrhagic and infectious complications and length of stay of patients in hospital. BTUR vs MTUR showed the possibility of a significant reduction in blood loss and surgical injuries during surgery, as well as early complications of an infectious and inflammatory nature. The clinical effectiveness in terms of the frequency of complications, repeated surgical interventions and dynamics of urological indicators was the best for BTUR and TUEB at 1 month and statistically similar at 6 months after surgery. Therefore, the introduction of new bipolar methods of transurethral surgery can speed up the recovery period, reduce the cost of hospitalization and improve the quality of surgical care for BPH.

Keywords:benign prostatic hyperplasia, bipolar transurethral resection and enucleation of the prostate.