None listed
Conditions
Brief summary
The surgical management of patients with prostate greater than 80ml that cause bladder outflow obstruction secondary to benign prostatic hyperplasia (BPH) is a challenging area.AUA and EAU guidelines suggest that open prostatectomy should be the treatment of choice in patients with a prostate volume of greater than 80ml. Transvesical prostatectomy (TVP) is a popular open prostatectomy, however, the application of it for large prostate has been progressively decreasing over the years following the rapid advent of minimally invasive techniques. Transurethral enucleation and resection of prostate (TUERP) with Gyrus Plasma Kinetic System is an unique surgery which was initiated by a Chinese doctor and popularized around the country and propagated to the world in AUA Meeting (2006). The unique feature of this procedure is that prostate is transurethrally enucleated and resected with bipolar plasmakinetic resectoscope. Previous studies reported the satisfactory efficacy and safety of TUERP in treating BPH, however, prostate volume in these report ranged from small to large size. Our goal is to assess the efficacy and safety of TUERP in treating BPH with prostate greater than 80 ml. If it does work, it will provide a new minimally invasive technique for large prostate.
Interventions
transvesical prostatectomy (TVP) (1.5hours): The prostate is enucleated through abdominal routh, this is an open surgery. Surgeon removes the adenoma bluntly via finger dissection.
and transurethral enucleation and resection of the prostate (TUERP)(1.5hours): this is a transurethral procedure. Steps: to develop the plane of surgical capsule at the level closely proximal to the verumontanum with vaporization, dissecting the adenoma off the capsule plane by unclenching the adenoma bluntly using t
transvesical prostatectomy (TVP) (1.5hours): The prostate is enucleated through abdominal routh, this is an open surgery. Surgeon removes the adenoma bluntly via finger dissection. and transurethral enucleation and resection of the prostate (TUERP)(1.5hours): this is a transurethral procedure. Steps: to develop the plane of surgical capsule at the level closely proximal to the verumontanum with vaporization, dissecting the adenoma off the capsule plane by unclenching the adenoma bluntly using the beak of the resectoscope sheath from one side to the other, just like finger dissection in TVP procedure. The blood vessels to the adenoma were coagulated at the time of dissection. When the whole adenoma was almost dissected off the capsule, a small proportion of adenoma was allowed to anchor the capsule at the bladder neck which helped the surgeon to harvest the whole adenoma into pieces with resection. The adenoma slices can be evacuated manually.
Sponsors
xie, keji
Study design
Allocation
Randomised controlled trial
Primary purpose
Treatment
Eligibility
Sex/Gender
Male
Age
50 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
benign prostate hyperplasia (BPH) with prostate>80ml: The prostate volume is measured by transrectal ultrasound conform to this equation: the volume equals 0.52 × (L × W × H), where L is the maximum length (craniocaudal dimension), H is the maximum height (anteroposterior dimension), both were obtained from the sagittal plane, W is the maximum width (transverse dimension) obtained from the transverse plane.
Exclusion criteria
neurologic problem and Bladder stone
Outcome results
None listed