Tratamiento endoscópico de la hiperplasia benigna de próstata bajo anestesia local-sedación en pacientes de alto riesgo

Navalón Verdejo, P.; Sánchez Ballester, F.; Ordoño Domínguez, F.; Pallás Costa, Y.; Juan Escudero, J.; Cánovas Ivorra, J.A.

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Actas Urológicas Españolas

Print version ISSN 0210-4806

Abstract

NAVALON VERDEJO, P. et al. Endoscopic treatment of the benign prostatic hyperplasia with local anesthesia and sedation in patients with high surgical or anaesthesical risk. Actas Urol Esp [online]. 2006, vol.30, n.1, pp.46-52. ISSN 0210-4806.

Introduction and objetive: The aging of the population causes an increase of the number of men affected by benign prostatic hyperplasia (BPH) with a large number of pathology associated that may limit its surgical treatment. In this study we try to show the effectiveness and security of local anaesthesia and sedation in the endoscopic treatment of the BPH in patients with high surgical-anaesthetic risk. Methods: During the last 4 years, 38 patients underwent surgical treatment of BPH with ages between 78 and 86 years (average 81,4± 3,2) with severe obstructive prostatic syndrome and high surgical-anaesthetic risk. 15 patients underwent, transurethral incision of prostate (TUIP) and in 23 patients, transurethral resection (TURP) was performed. The blockade anesthetic was made by transrectal periprostatic infiltration finger-guided with 10-15 millilitres of lidocaine 2%. During the procedure an intravenous perfusion of propofol and remifentanil was administered. The obtained results as well as the patients satisfaction degree was evaluated by means of the elaboration of a questionnaire. Results: The average length of the surgical treatment was of 12 ± 5 minutes (rank 8 - 25), having itself not stated complications derived from the anesthetic technique. They referred a slight annoyance 4 patients (11%) that was treated increasing the rate of the sedative perfusión. The satisfactions degree with the received treatment has been good in the 95% of patients. Conclusions: We considered that the TUIP as much as TURP made under local anesthesia with sedation are safe, effective methods and well tolerated, that fundamentally are indicated in aged patients and when the surgical-anesthetic risk is elevated.

Keywords : Benign prostatic hyperplasia; Local anaesthesia; Transurethral prostatic resection.

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