Pariser Joseph J, Packiam Vignesh T, Adamsky Melanie A, Bales Gregory T
Section of Urology, Department of Surgery, The University of Chicago Medicine, 5841 S. Maryland Ave. MC6038, Chicago, IL, 60637, USA.
Curr Urol Rep. 2016 Aug;17(8):57. doi: 10.1007/s11934-016-0610-6.
The definitive treatment for symptomatic large volume (>80 mL) benign prostatic hyperplasia (BPH) is simple prostatectomy (SP). This can be performed by utilizing a retropubic, suprapubic, or a combined approach. The latter two approaches allow for the management of concomitant bladder diverticulum or stones through the same incision. Each approach affords unique technical strengths and weaknesses that must be considered in light of patient characteristics and concomitant pathology. SP allows for removal of the entire prostatic adenoma while obviating some of the neurovascular and continence issues that can arise from radical prostatectomy. Concerns with SP include its relatively high perioperative morbidity, notably bleeding. Therefore, there is increasing interest in less invasive options, including enucleation procedures and minimally invasive SP. This review presents an update regarding trends and outcomes of SP, as well as the effectiveness and popularity of alternative treatments.
有症状的大容量（>80毫升）良性前列腺增生（BPH）的确定性治疗方法是单纯前列腺切除术（SP）。这可以通过耻骨后、耻骨上或联合入路来进行。后两种入路允许通过同一切口处理合并的膀胱憩室或结石。每种入路都有其独特的技术优缺点，必须根据患者特征和合并的病理情况加以考虑。SP能够切除整个前列腺腺瘤，同时避免了根治性前列腺切除术可能出现的一些神经血管和控尿问题。对SP的担忧包括其相对较高的围手术期发病率，尤其是出血。因此，人们对侵入性较小的选择越来越感兴趣，包括剜除术和微创SP。本综述介绍了SP的趋势和结果，以及替代治疗的有效性和普及情况的最新进展。
