Dr. med. Dirk Manski



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Retropubic Simple Prostatectomy (Millin)


fig. principle of retropubic simple prostatectomy, popularized by Millin:
A) sagittal section through the prostate adenoma
B) transverse capsulotomy and mobilization of the prostatic adenoma
C) situs after simple prostatectomy with hemostatic sutures at the bladder neck and closure of prostatic capsule. An irrigation catheter is blocked in the prostatic fossa.
figure: surgical principle of retropubic simple prostatectomy for BPH

Indications for Retropubic Simple Prostatectomy

Retropubic adenomectomy of the prostate is indicated for the surgical treatment of benign prostatic hyperplasia with very large adenoma (> 75 ml). The retropubic approach offers the advantage of better hemostasis and improved vision for the apical adenomectomy. The retropubic approach is not ideal for large middle lobes and significant obesity. Consider the transvesical suprapubic approach for large bladder stones or bladder diverticula.

Contraindications to Retropubic Prostatectomy

Prostate cancer, small prostate (prefer TURP), low life expectancy, coagulation disorders, untreated urinary tract infection.

Surgical Technique of Retropubic Simple Prostatectomy

Preoperative Patient Preparation

Surgical Approach:

Dissection of the Prostatic Adenoma:

Hemostasis after Retropubic Prostatectomy:

Wound Closure:

Postoperative Management after Retropubic Prostatectomy

Complications of Retropubic Prostatectomy







Index: 1–9 A B C D E F G H I J K L M N O P Q R S T U V W X Y Z



References



  Deutsche Version: transvesikale Adenomektomie