Laparoscopic Retropubic Simple Prostatectomy for Large Benign Prostatic Hyperplasia: First Case Report in Thailand
Tanet Thaidumrong MD*, Danaiphand Akarasakul MD*
Affiliation : * Division of Urology, Department of Surgery, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand
Background and
Objective : At Rajavithi Hospital, open retropubic simple prostatectomy was started in 1985. The purpose
of the present was to describe a surgical technique and early post-operative results of the first successful laparoscopic
retropubic simple prostatectomy (LRSP) in Thailand.
Case Report : A 69-year-old Thai male presented with a chief complaint of refractory urinary retention. Digital rectal
examination was performed with prostate gland of 4 finger breadths, firm consistency and smooth surface. The PSA level was
27.16 ng/ml. Transrectal ultrasound volume was 143 gm. The biopsy sample confirmed BPH and chronic prostatitis. The
cystoscopy revealed prostate gland enlargement with obstruction. This patient’s manifestation required surgical treatment of
BPH, and the LRSP technique was chosen. The prostatic capsule was incised by monopolar scissors and the prostatic
adenoma was enucleated. The prostatic capsule was closed and a 22 Fr three-way irrigating Foley catheter was inserted. The
operative time was 2 hours, with estimated blood loss of 600 ml and no immediate post-operative complications. The prostate
specimen weighed 169 gm. The pathologic results confirmed BPH and prostatitis. Postoperative ambulation and catheter
removal was on the 2nd and the 7th day, respectively. Postoperative uroflowmetry report showed a Qmax of 15 ml/s.
Conclusion : Operated by an experienced laparoscopic team, laparoscopic retropubic simple prostatectomy for large BPH
is a feasible alternative approach to open surgery.
Keywords : Laparoscopic retropubic simple prostatectomy, Benign prostatic hyperplasia, Case report, Thailand
