Three-year experience of treatment of patients with benign prostatic hyperplasia: from open surgery to a bipolar enucleation
DOI:
https://doi.org/10.25726/NM.2019.48.73.005Keywords:
benign prostatic hyperplasia, bipolar transurethral enucleation of the prostate, surgery, methods, prostate, patientsAbstract
The article presents the experience of the introduction of a new method of treatment of benign prostatic hyperplasia (BPH) - transurethral bipolar prostate enucleation (TUEB) in a set of surgical methods of the urological Department of the "Clinical hospital "Russian Railways - Medicine" of Saratov. Statistical data on control were obtained by retrospective method from the archive of medical records. Statistical processing of the results of the study was carried out using the parametric t-student test. The differences were considered significant at the significance level p ≤ 0.05.
The analysis of the general operating results and clinical effectiveness of the new method (89 people) was carried out in comparison with the retrospective data on the method of open prostatectomy (OPE - 91 people), previously used in the Department for the treatment of patients of this profile.
It was found that the use instead of OPE for medium and large volumes of BPH allows 2-3 times to reduce blood loss during surgery, the timing of postoperative drainage of the bladder and the total duration of hospitalization with a minimum amount of intra- and postoperative bleeding and in the absence of complications of infectious and inflammatory nature.
The results indicate the prospects instead of traumatic OPE, as it allows to optimize the surgical results and economic indicators of treatment of BPH.
References
2. Apolikhin O.I., Sivkov A.V., Moskaleva N.G., Solntseva T.V., Komarova V.A. (2014). Analiz urologicheskoj zabolevaemosti i smertnosti v Rossijskoj Federacii za desjatiletnij period (2002–2012) [Analysis of urological morbidity and mortality in the Russian Federation over a ten-year period (2002-2012)]. Jeksperimental'naja i klinicheskaja urologija [Experimental and clinical urology], 2, 4-12. (In Russ.)
3. Vertkin A. L., Polosyants O. B., Keshokov R. Kh. (2008). Dobrokachestvennaja giperplazija predstatel'noj zhelezy i ee oslozhnenija v obshhemedicinskoj praktike [Benign prostatic hyperplasia and its complications in general medical practice]. Consilium Medicum, 4(4), 14-22. (In Russ.)
4. Kalininskaya A.A., Mashin A.G., Sevryukov F.A. (2013). Faktory riska razvitija giperplazii predstatel'noj zhelezy [Risk factors for developing prostatic hyperplasia]. Social'nye aspekty zdorov'ja naselenija [Social aspects of public health], 29(1), 1-9. (In Russ.)
5. Kamalov A.A., Sevryukov F.A. (2012). Izuchenie jeffektivnosti bipoljarnoj transuretral'noj rezekcii adenomy prostaty srednih i malyh razmerov [Study of the effectiveness of bipolar transurethral resection of adenomas of the prostate of medium and small sizes]. Sovremennye tehnologii v medicine [Modern technologies in medicine], 4, 68-72. (In Russ.)
6. Kamyshov S.V., Nishanov D.A., Pulatov D.A., Yuldasheva N.Sh. (2017). Izuchenie markerov apoptoza, proliferacii i angiogeneza u bol'nyh rakom jaichnika, poluchivshih soprovoditel'nuju immunoterapiju [The study of markers of apoptosis, proliferation and angiogenesis in patients with ovarian cancer who received accompanying immunotherapy]. Zlokachestvennye opuholi [Malignant tumors], 1, 84-91. (In Russ.)
7. Kamyshov S.V., Pulatov D.A., Nishanov D.A., Yuldasheva N.Sh., Yusupova N.B. (2017). Znachimost' ocenki molekuljarno-biologicheskih onkomarkerov v soprovoditel'noj immunoterapii pri rake shejki matki [Significance of the assessment of molecular biological tumor markers in accompanying immunotherapy for cervical cancer]. Onkologija i radiologija Kazahstana [Oncology and radiology of Kazakhstan], 2, 45-48. (In Russ.)
8. Kamyshov S.V., Pulatov D.A., Yuldasheva N.Sh. (2017). Ispol'zovanie metodov gravitacionnoj hirurgii krovi v kompleksnom lechenii bol'nyh rakom jaichnika [The use of gravitational blood surgery methods in the complex treatment of patients with ovarian cancer]. Vestnik Nacional'nogo mediko-hirurgicheskogo centra im. N.I. Pirogova [Bulletin of the National Medical and Surgical Center after N.I. Pirogov], 12(1), 52-56. (In Russ.)
9. Kamyshov S.V., Yuldasheva N.Sh., Salimova L.R. 2010. Vozmozhnosti ispol'zovanija jekstrakorporal'noj immunofarmakoterapii v kombinirovannom lechenii raka shejki matki [Possibilities of using extracorporeal immunopharmacotherapy in the combined treatment of cervical cancer]. Onkologija i radiologija Kazahstana [Oncology and radiology of Kazakhstan], 3-4 (16-17), 95-96. (In Russ.)
10. Kovshik V.S., Savrova O.B. (2017). Sravnitel'nyj analiz faktorov riska razvitija raka predstatel'noj zhelezy [Comparative analysis of risk factors for prostate cancer]. Jelektronnyj nauchno-obrazovatel'nyj vestnik. Spec. vypusk «Zdorov'e i obrazovanie v XXI veke» [Electron. scientific and educational bulletin. Specialist. issue "Health and education in the XXI century"], 19 (2), 135-136. (In Russ.)
11. Kulikova N.G., Kamurzoeva S.Sh. (2014). Mediko-social'nye osobennosti bol'nyh trudosposobnogo vozrasta s pervichnoj invalidnost'ju [Medical and social characteristics of patients of working age with primary disability]. Problemy social'noj gigieny, zdravoohranenija i istorii mediciny [Problems of social hygiene, health care and the history of medicine], 22(2), 14-16. (In Russ.)
12. Pulatov D.A., Ibragimov Zh.M., Kamyshov S.V. (2017). Sravnitel'naja ocenka toksichnosti lechenija bol'nyh himiorezistentnym kolorektal'nym rakom [Comparative evaluation of the toxicity of treatment of patients with chemoresistant colorectal cancer]. Onkologija i radiologija Kazahstana [Oncology and radiology of Kazakhstan], 2, 58-61. (In Russ.)
13. Sevryukov F.A. (2012). Kachestvo zhizni bol'nyh posle transuretral'noj jenukleacii adenomy predstatel'noj zhelezy bol'shih razmerov [The quality of life of patients after transurethral enucleation of large prostate adenomas]. Andrologija i genital'naja hirurgija [Andrology and genital surgery], 13(3), 42-46. (In Russ.)
14. Sevryukov F.A., Kamaev I.A., Mushroom M.N., Perevezentsev E.A. (2011). Osnovnye aspekty obespechenija vysokokvalificirovannoj urologicheskoj medicinskoj pomoshh'ju bol'nyh s dobrokachestvennoj giperplaziej predstatel'noj zhelezy [The main aspects of providing highly qualified urological medical care to patients with benign prostatic hyperplasia]. Rossijskij mediko-biologicheskij vestnik imeni akademika I.P. Pavlova [I.P. Pavlov Russian Medical Biological Herald], 19(1), 109-113. (In Russ.)
15. Sevryukov F.A., Kamaev I.A., Mushroom M.N., Perevezentsev E.A., Malinina O.Yu., Elina Yu.A. (2011). Faktory riska i kachestvo zhizni bol'nyh s dobrokachestvennoj giperplaziej predstatel'noj zhelezy [Risk factors and quality of life in patients with benign prostatic hyperplasia]. Rossijskij mediko-biologicheskij vestnik imeni akademika I.P. Pavlova [I.P. Pavlov Russian Medical Biological Herald], 3, 48-52. (In Russ.)
16. Sevryukov F.A., Kochkin A.D., Sorokin D.A., Semenychev D.V., Knutov A.V. (2015). Bipoljarnaja transuretral'naja jenukleacija gigantskoj adenomy prostaty [Bipolar transurethral enucleation of giant prostate adenoma]. Tihookeanskij medicinskij zhurnal [Pacific Medical Journal], 4, 72-74. (In Russ.)
17. Sevryukov F.A., Malinina O.Yu., Elina Yu.A. (2011). Osobennosti medicinskogo obespechenija pacientov s dobrokachestvennoj giperplaziej predstatel'noj zhelezy na jetape ambulatorno-poliklinicheskoj pomoshhi [Features of medical support for patients with benign prostatic hyperplasia at the stage of outpatient care]. Medicinskij al'manah [Medical almanac], 1, 25-27. (In Russ.)
18. Sevryukov F.A., Puchkin A.B., Krupin V.N., Chebykin A.V., Sorokin D.A., Karpukhin I.V., Malinina O.Yu., Zorin D.G. (2007). Transuretral'naja jelektrohirurgija novogo pokolenija (TURIS) v lechenii zabolevanij nizhnih mochevyh putej i prostaty [New Generation Transurethral Electrosurgery (TURIS) in the treatment of diseases of the lower urinary tract and prostate]. Urologija [Urology], 3, 28-35. (In Russ.)
19. Semenychev D.V., Sevryukov F.A., Sorokin D.A., Karpukhin I.V., Puchkin A.B., Kochkin A.D., Knutov A.V. (2015). Sravnitel'naja ocenka bipoljarnoj transuretral'noj vaporezekcii (TUVRB) i bipoljarnoj rezekcii (TURIS) v lechenii dobrokachestvennoj giperplazii prostaty [Comparative evaluation of bipolar transurethral vapor resection (TUVRB) and bipolar resection (TURIS) in the treatment of benign prostatic hyperplasia]. Medicinskij vestnik Bashkortostana [Medical Bulletin of Bashkortostan], 10(3), 16-19. (In Russ.)
20. Sivkov A.B. (2010). Dobrokachestvennaja giperplazija predstatel'noj zhelezy: personal'nyj vzgljad [Benign prostatic hyperplasia: personal view]. Urologija segodnja [Urology today], 6, 7-11. (In Russ.)
21. Alyaeva P.V. Glybochko D.Yu., Pushkarja D.Ju. (eds.) (2016). Urologija. Rossijskie klinicheskie rekomendacii [Urology. Russian Clinical Recommendations]. Moscow: GEOTAR-Media, 496.
22. Khamurzoeva S.Sh., Kulikova N.G. (2013). Puti snizhenija invalidnosti u lic trudosposobnogo vozrasta [Ways to reduce disability in people of working age]. Problemy social'noj gigieny, zdravoohranenija i istorii mediciny [Problems of social hygiene, health care and the history of medicine], 6, 29-31.
23. Chen S., Zhu L, Cai J, Zheng Z, Ge R, Wu M, et al. (2014). Plasmakinetic enucleation of the prostate compared with open prostatectomy for prostates larger than 100 grams: A randomized noninferiority controlled trial with long-term results at 6 years. Eur Urol., 66, 284-291.
24. da Silva R.D., Bidikov L., Michaels W. et al. (2015). Bipolar energy in the treatment of benign prostatic hyperplasia: a current systematic review of the literature. Can J Urol, 22 Suppl 1, 30-44.
25. Gratzke C. et al. (2015). EAU Guidelines on the Assessment of Non-neurogenic Male Lower Urinary Tract Simptoms including Benign Prostatic Obstruction. European Urology, 67(6), 1099-1109.
26. Geavlete B., Stanescu F., Iacoboaie C., Geavlete P. (2013). Bipolar plasma enucleation of the prostate vs open prostatectomy in large benign prostatic hyperplasia cases. A medium term, prospective, randomized comparison. BJU Int., 111(5), 793-803.
27. Li M., Qiu J., Hou Q. et al. (2015). Endoscopic enucleation versus open prostatectomy for treating large benign prostatic hyperplasia: a meta-analysis of randomized controlled trials. PLoS One, 10(3), e0121265.
28. Ou R.B., Deng X.R., Yang W.J., Wei X.H., Chen H., Xie K.J. (2013). Transurethral enucleation and resection of the prostate vs transvesical prostatectomy for prostate volumes > 80mL: a prospective randomized study. BJU Int., 112, 239-245.
29. Qiu J., Hou Q. et al. (2015). Endoscopic enucleation versus open prostatectomy for treating large benign prostatic hyperplasia: a meta-analysis of randomized controlled trials. PLoS One, 10(3), e0121265.