Extraperitoneal laparoscopic adenomectomy for benign prostatic hyperplasia.

OBJECTIVES

We assessed the feasibility of extraperitoneal laparoscopic prostatectomy in pilots in China.

MATERIALS AND METHODS

Extraperitoneal laparoscopic retropubic prostatectomy has been performed in 45 patients with prostatic weight more than 60 g between May 2005 and May 2008. The laparoscopic approach was standard in all cases as follows: creation of a preperitoneal workspace, haemostatic control of lateral venous vesicoprostatic pedicles, transversal anterior incision of the prostate capsule, prostatic adenomectomy and retrieval of the specimen.

RESULTS

The average prostate resected weight was 78.2 +/- 16.3 g. Mean operative time was 105.4 +/- 26.5 min. Conversion to open prostatectomy was not required. The transfusion was essential in three cases. During a 6 months follow-up period for 40 cases, the mean score of IPSS decreased from 25.5 +/- 2.4 to 6.2 +/- 2.1, Q(max) increased from 6.1 +/- 2.8 to 18.7 +/- 3.4 ml/s. None of the patients presented with urinary incontinence.

CONCLUSIONS

In our experience, laparoscopic extraperitoneal adenomectomy (Millin's procedure) is feasible with minimal invasion and is a simple straightforward technique.