Laparoscopic versus Open Simple Prostatectomy: An Evaluation of Morbidity

Purpose: To evaluate the morbidity between laparoscopic simple prostatectomy (LSP) and open simple prostatectomy (OSP) in the management of benign prostatic hyperplasia. Patients and Methods: From January 2003 through January 2008, 280 consecutive patients underwent adenomectomy either by an extraperitoneal laparoscopic transcapsular "Millin" approach (96 patients, 34.3%) or open transvesical approach (184 patients, 65.7%). Medical therapy had failed in all patients. Perioperative and outcome data were recorded and compared. Results: There was no significant difference in patient age, prostate size, uroflow rate, mean International Prostate Symptom Score, operative blood loss, or total time of continuous bladder irrigation between the two groups. Mean operative time was significantly longer in the laparoscopy group, 95.1 +/- 32.9 minutes, v the open group at 54.7 +/- 19.7 minutes (P < 0.0001). Total catheter time was significantly shorter in the laparoscopy group (5.2 +/- 2.6 v 6.4 +/- 2.9 days; P < 0.001) as was length of hospital stay (6.3 +/- 1.9 v 7.7 +/- 2.4 days; P < 0.0001). The most common complication between the two groups was hemorrhage, occurring in 27 (28.1%) patients in the laparoscopy group and 54 patients (29.3%) in the open group. Of the 19 urinary tract infections observed between the two groups, 18 occurred in the open group as well as all 9 cases of urinary sepsis. Conclusions: LSP offers advantages over OSP in terms of shorter catheter time, shorter hospital length of stay, and fewer urinary tract infections.