An Alternative Minimally Invasive Technique for Large Prostates (> 80 mL): Transvesical Prostatectomy Through a 3-cm Incision

OBJECTIVES To assess the efficacy and the simplicity of a modified open transvesical prostatectomy for large prostates (>80 mL). METHODS A total of 165 patients with benign prostatic hyperplasia were treated with transvesical prostatectomy through a 3-cm incision. Prostate size was 85-144 cm(3) (mean 101 cm3). Surgery is performed as the standard transvesical prostatectomy but skin incision is much smaller (proximately 3 cm), whereas muscle incision underneath is about 7 cm long. Prostate adenoma was removed with finger dissection without the placement of hemostatic sutures. RESULTS Operation time was 15-36 minutes (mean 24 minutes). Catheter was removed on the third day and patients left the hospital after successful voiding. Preoperative hematocrit was 40.6-49.2 (mean 43.4), while postoperative hematocrit was 28.3-42.4 (mean 38.3). Transfusion rate was 0-3 blood units (mean 1 U). Mean preoperative flow was 11.5 cm/s and mean postoperative flow was 22.3 cm/s. Mean IPSS score improve from 28 preoperatively to 15 postoperatively. CONCLUSIONS Open transvesical prostatectomy with a 3-cm incision is a minimally invasive technique for the treatment of large prostates (>80 mL) in which transurethral prostatectomy or laser prostatectomy may not be the first choice. UROLOGY 75: 184-186, 2010. (C) 2010 Elsevier Inc.