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Rotoresection for benign prostatic hyperplasia
Benign prostatic hyperplasia is a common problem in dogs but also in men. This study about short-term results, safety and efficacy of rotoresection in men is very informative although castration remains the therapy of choice is veterinary medicine...

The objective of this study was to assess the safety and efficacy of rotoresection as a method for treating benign prostatic hyperplasia (BPH).

Thirty patients were prospectively enrolled between September 2000 and May 2001 (mean age 61 years, sd 6, range 52–78).

All patients had a symptom score (AUA) of > 12, a maximum urinary flow rate (Qmax) of < 12 mL/s, a prostate of 20–80 mL and a prostate-specific antigen (PSA) level of 0–4 ng/mL.

Patients with prostate or bladder cancer, a PSA level of > 10 ng/mL, previous prostate surgery, previous pelvic surgery, urethral stricture, active urinary tract infection (UTI), acute urine retention, neuropathic bladder and a serum creatinine of > 1.8 mg/mL were excluded.

The adenoma was resected using the Rotoresect® system (Karl Storz, Tuttlingen, Germany); the mean (sd) operative duration was 45.2 (9.9) min. The catheter was removed after 1.97 (0.3) days and patients assessed at 1, 3 and 6 months after surgery by an AUA score, Qmax, blood haemoglobin level, urine analysis and transrectal ultrasonography; all patients but two completed the follow-up.

RESULTS: At 6 months the mean (sd) AUA score decreased from 20.5 (3.8) to 1.6 (1.3), the Qmax increased from 8.7 (2) to 25.3 (12.6) mL/s, and the total prostate volume decreased from 36.5 (13) to 20.5 (7.8) mL.

The mean initial haemoglobin level was 138 (10) g/L and at 1 month was 135 (12) g/L. No patient required a blood transfusion or had signs of transurethral resection syndrome.

Early complications included UTI and mild stress incontinence in 10 and 11 patients, respectively. At 6 months these patients had sterile urine and were continent.

Two patients had a urethral stricture and posterior urethral stone at 6 months and were treated successfully.

CONCLUSION: In the short-term, rotoresection is a safe and effective method for treating BPH; there was no significant blood loss or resection syndrome. The hospital stay was short, with excellent functional results.



Source: B.S. Wadie, A.B. Shehab El-Dein, A.M. Mohamed, S.M. Elhalwagy, M.A. Ghoneim (2003): Short-term results of rotoresection for benign prostatic hyperplasia: a prospective study of safety and efficacy. In: BJU International 92 (7) , 710–712



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