Photoselective vaporisation of the prostate (PVP) combined with laparoscopic urinary bladder diverticulectomy
Abstract
Introduction: Pseudodiverticulum of urinary bladder is usually associated with Bladder Outlet Obstruction (BOO). Trdaditionally the most common surgical management was open prostatectomy with diverticulectomy (D).
More recently, two-stage endoscopic procedures have been usedFirstly, TURP,followed by laparoscopic diverticulectomy (LD). We present the option of a single operation using green laser photoselective vaporization of the prostate (PVP) and LD.
Material: From 1/2011 to 7/2015, 18 LDs were performed. The mean age was 62.4+-10.0 (36.0 to 75.1).
The size of diverticulum was 62.2+-22.5 (26-120) mm. In three cases only the diverticulum was treated, twice with laparoscopic radical prostatectomy and 13x combined with BPH treatment.
In 4 cases TURP was performed before LD. In 9 cases LD was combined simultaneously with PVP. 187 Ces Urol 2015; 19(3): 185-187 VIDEO As a part of the preoperative examination 3D CT cystography or better CT IVU (for better imagining of the relationship between ureters and diverticulum) were used.
Conclusion: Resolution of subvesical obstruction with urinary bladder diverticulectomy is not a common procedure in daily practice. The combination of PVP and LD is a modern minimally invasive method.
We currently intend to give it a clear preference in clinical practice to the other methods. It is only isadvantageous from the point of fi nancing using our DRG system, which is more profi table with a two stage procedure.