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Retropubic Prostatectomy- Innovations to Reduce Complications Leading to Smooth Recovery

Received: 25 January 2017     Accepted: 9 March 2017     Published: 20 March 2017
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Abstract

Introduction: Open prostatectomy/adenoma enucleation remains a valuable surgical option in treating large obstructing prostates in patients with large gland volume. We report our series of retropubic prostatectomies with innovative methods to reduce the complications and lead to smooth recovery. Patients and Methods: A total of 75 patients with B PH were treated by retropubic prostatectomy from 2005 to 2015. Patient’s demographical, clinical, pre- and postoperative data and final histology were recorded. 3 way Foley’s catheter before surgery was kept in the bladder and haemostasis was obtained by applying traction over the prostatic fossa. Results: The mean weight of prostatic adenoma was 82 gm., the smallest being 70gm. and the largest 192gm. Only 2 patients required intra operative blood transfusion. The catheter was removed on the 5th post-operative day. 94% of the patients voided with a good stream with little discomfort after one week. only one patient had incontinence of urine which improved subsequently over a period of 6 to 8 weeks. There was no mortality and no re-exploration for clot retention was required in any patient, Conclusion: Millin's prostatectomy popularized over half a century ago continues to be a valuable option for the surgical treatment of high-volume prostate glands with excellent outcomes for patients with innovative methods.

Published in Journal of Surgery (Volume 5, Issue 2)
DOI 10.11648/j.js.20170502.11
Page(s) 15-17
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2017. Published by Science Publishing Group

Keywords

Prostatectomy, Clot Retention, Millin’s Prostatectomy

References
[1] Mariano MB, Tefilli MV, Graziottin TM, Morales CM, Goldraich IH. Laparoscopic prostatectomy for benign prostatic hyperplasia – a six-year experience. Eur Urol 2006; 49: 127–31.
[2] Kuntz RM. Current role of lasers in the treatment of benign prostatic hyperplasia (BPH). Eur Urol 2006; 49: 961-9.
[3] Adam C, Hofstetter A, Deubner J, Zaak D, Weitkunat R, Seitz M et al. Retropubic transvesical prostatectomy for significant prostatic enlargement must remain a standard part of urology training. Scand J Urol Nephrol 2004; 38: 472–6.
[4] Bellfield WT. Operations on the enlarged prostate with a tabulated summary of cases. Am J Med Sci 1890: 100: 439.
[5] FreyerP. A new method of performing prostatectomy. Lancet 1900: 1: 774.
[6] Millin T. Retropubic prostatectomy. A new extravesical technique. Report on 20 cases. Lancet 1945: 2: 693.
[7] Millin T. Retropubic Prostatectomy. J Urol 1948: 59: 267-274.
[8] Walsh PC. Osterling JE. Improved hemostasis during simple retropubic prostatectomy. J Urol 1990: 143: 1203-04.
[9] Subrahmanyam. M. A simple technique to achieve homeostasis and prevent clot retention in suprapubic prostatectomy. Tropical doctor 1998, 28: 250.
[10] Holtgrewe HL. Economic issues and the management of benign prostatic hyperplasia. Urology 1995. 143: 2013-14.
[11] Mebust WK, Holtgrewe HL, Cockett ATK, Peters PC and writing committee. Transurethral prostatectomy: immediate and postoperative complications. A co-operative study of thirteen participating institutions evaluating 3,885 patients. J Urol 1989: 141: 243-247.
[12] Dettmar H. Modification of technique for retropubic prostatectomy: Report of 100 cases. J Urol 1959; 81: 558-561.
[13] Long RM, Thomas AZ, Browne C, Aisinnawi M, Ul-islam J, McDermott TE etal. A 30-year experience of Millin's retropubic prostatectomy: Has this classic operation derived by a President of the College in Ireland stood the test of time? Ir J Med Sci. 2015, 184: 341-4.
[14] Zargooshi J. Open prostatectomy for benign prostate hyperplasia: short-term outcome in 3000 consecutive patients. Prostate Cancer and Prostatic Diseases 2007, 10; 374–77.
[15] Trivedi VD, 3 Anandkar MG, SAlve -Satwekar A clinical revie w of fifty consecutive cases of retropubic prostatectomy for benign prostatic hyperplasia. Indian journal of urology 2000, 16: 122-25.
[16] Zambolin T, Scamzi M, Tralceh, De Luca V, Magri V, Panizz E et al. Retropubic adenectomy (Millin’s technique). Our experience. Arch. Ital. urol. Androl. 1995, 67: 105-7.
[17] Servadio C. Is open prostatectomy really obselete? Urology 1992, 40: 419-21.
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  • APA Style

    M. Subrahmanyam, G. Vamshikrishna, G. Harikrishna. (2017). Retropubic Prostatectomy- Innovations to Reduce Complications Leading to Smooth Recovery. Journal of Surgery, 5(2), 15-17. https://doi.org/10.11648/j.js.20170502.11

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    ACS Style

    M. Subrahmanyam; G. Vamshikrishna; G. Harikrishna. Retropubic Prostatectomy- Innovations to Reduce Complications Leading to Smooth Recovery. J. Surg. 2017, 5(2), 15-17. doi: 10.11648/j.js.20170502.11

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    AMA Style

    M. Subrahmanyam, G. Vamshikrishna, G. Harikrishna. Retropubic Prostatectomy- Innovations to Reduce Complications Leading to Smooth Recovery. J Surg. 2017;5(2):15-17. doi: 10.11648/j.js.20170502.11

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  • @article{10.11648/j.js.20170502.11,
      author = {M. Subrahmanyam and G. Vamshikrishna and G. Harikrishna},
      title = {Retropubic Prostatectomy- Innovations to Reduce Complications Leading to Smooth Recovery},
      journal = {Journal of Surgery},
      volume = {5},
      number = {2},
      pages = {15-17},
      doi = {10.11648/j.js.20170502.11},
      url = {https://doi.org/10.11648/j.js.20170502.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20170502.11},
      abstract = {Introduction: Open prostatectomy/adenoma enucleation remains a valuable surgical option in treating large obstructing prostates in patients with large gland volume. We report our series of retropubic prostatectomies with innovative methods to reduce the complications and lead to smooth recovery. Patients and Methods: A total of 75 patients with B PH were treated by retropubic prostatectomy from 2005 to 2015. Patient’s demographical, clinical, pre- and postoperative data and final histology were recorded. 3 way Foley’s catheter before surgery was kept in the bladder and haemostasis was obtained by applying traction over the prostatic fossa. Results: The mean weight of prostatic adenoma was 82 gm., the smallest being 70gm. and the largest 192gm. Only 2 patients required intra operative blood transfusion. The catheter was removed on the 5th post-operative day. 94% of the patients voided with a good stream with little discomfort after one week. only one patient had incontinence of urine which improved subsequently over a period of 6 to 8 weeks. There was no mortality and no re-exploration for clot retention was required in any patient, Conclusion: Millin's prostatectomy popularized over half a century ago continues to be a valuable option for the surgical treatment of high-volume prostate glands with excellent outcomes for patients with innovative methods.},
     year = {2017}
    }
    

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    T1  - Retropubic Prostatectomy- Innovations to Reduce Complications Leading to Smooth Recovery
    AU  - M. Subrahmanyam
    AU  - G. Vamshikrishna
    AU  - G. Harikrishna
    Y1  - 2017/03/20
    PY  - 2017
    N1  - https://doi.org/10.11648/j.js.20170502.11
    DO  - 10.11648/j.js.20170502.11
    T2  - Journal of Surgery
    JF  - Journal of Surgery
    JO  - Journal of Surgery
    SP  - 15
    EP  - 17
    PB  - Science Publishing Group
    SN  - 2330-0930
    UR  - https://doi.org/10.11648/j.js.20170502.11
    AB  - Introduction: Open prostatectomy/adenoma enucleation remains a valuable surgical option in treating large obstructing prostates in patients with large gland volume. We report our series of retropubic prostatectomies with innovative methods to reduce the complications and lead to smooth recovery. Patients and Methods: A total of 75 patients with B PH were treated by retropubic prostatectomy from 2005 to 2015. Patient’s demographical, clinical, pre- and postoperative data and final histology were recorded. 3 way Foley’s catheter before surgery was kept in the bladder and haemostasis was obtained by applying traction over the prostatic fossa. Results: The mean weight of prostatic adenoma was 82 gm., the smallest being 70gm. and the largest 192gm. Only 2 patients required intra operative blood transfusion. The catheter was removed on the 5th post-operative day. 94% of the patients voided with a good stream with little discomfort after one week. only one patient had incontinence of urine which improved subsequently over a period of 6 to 8 weeks. There was no mortality and no re-exploration for clot retention was required in any patient, Conclusion: Millin's prostatectomy popularized over half a century ago continues to be a valuable option for the surgical treatment of high-volume prostate glands with excellent outcomes for patients with innovative methods.
    VL  - 5
    IS  - 2
    ER  - 

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Author Information
  • Department of General Surgery, Kamineni Institute of Medical Sciences, Narketpally, T. S., India

  • Department of General Surgery, Kamineni Institute of Medical Sciences, Narketpally, T. S., India

  • Department of General Surgery, Kamineni Institute of Medical Sciences, Narketpally, T. S., India

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