UROFLOWMETRIC STUDIES IN PATIENTS AFTER OPEN AND MINIMALLY INVASIVE PROSTATECTOMY FOR BENIGN PROSTATIC HYPERPLASIA

ANNOTATION. Uroflowmetry is the only noninvasive urodynamic method for determining detrusor activity and urethral resistance during the voiding phase of the bladder. Uroflowmetry is a simple and valuable method for assessing lower urinary tract patency, especially in patients with benign prostatic hyperplasia (BPH). This method allows for an objective assessment of the act of urination in patients with BPH before and after surgery. THE AIM OF THE STUDY. To assess and compare the act of urination in patients with a prostate volume greater than 80 cm3 before and after open and minimally invasive prostatectomies. MATERIALS AND METHODS. The assessment of the act of urination was performed before and after single-stage open (retropubic and transvesical) prostatectomies and one-time minimally invasive (laparoscopic retropubic and robot-assisted transvesical) prostatectomies. The study was conducted in 120 patients with a prostate volume of more than 80 cm3: 30 — after one-time open retropubic (transcapsular) prostatectomy; 30 — after one-time open transvesical prostatectomy; 30 — after one-time laparoscopic extraperitoneal retropubic (transcapsular) prostatectomy; 30 — after one-time laparoscopic robot-assisted transvesical prostatectomy. Uroflowmetry was performed on a national uroflowmeter «Potik-K» (Dnipro) on the second day after removal of the urethral catheter or closure of the suprapubic fistula of the bladder during transvesical prostatectomy, as well as one month after the operation. RESULTS. The mean maximum volumetric urine flow rate (Qmax) after one-time open retropubic prostatectomy increased from 7.6±1.1 to 26.0±2.7 ml/s (p<0.01); after one-time open transvesical prostatectomy — from 7.2±1.4 to 25.2±2.6 ml/s (p<0.01); after one-time laparoscopic extraperitoneal retropubic prostatectomy — from 7.8±1.6 to 26.9±2.5 ml/s (p<0.01); after one-time laparoscopic robot-assisted transvesical prostatectomy — from 8.4±1.4 to 24.9±2.9 ml/s (p<0.01). One month after surgery, a statistically insignificant (p>0.05) decrease in Qmax was observed after all types of surgical interventions when compared with Qmax immediately after surgery. In our opinion, this is due to a decrease in detrusor overactivity as a result of healing and involution of the prostate bed wound, as well as inflammation in it. CONCLUSIONS. Both open (lobular, transvesical) and minimally invasive (laparoscopic, robot-assisted) prostatectomies are effective surgical interventions to restore urination in patients with large benign prostatic hyperplasia (more than 80 cm3).