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.