Future of BPH Surgery is Urethra Preserving!
Madigan prostatectomy was published in 1990. During open prostatectomy the urethra was preserved and the prostate lobes including middle lobes were removed. At no time during surgery and postoperatively urine and blood do not mix together. Catheter time is short. Most complications of BPH surgery are avoided.
I watched video of Lap Madigan Prostatectomy in Shanghai end of 2019. The series was of about 35 patients with excellent results.
I compare Ureter to prostatic urethra. Ureteric obstruction is classified as in the lumen: stone and we get patients with stone obstructed in the prostatic urethra. Ureteric obstruction in the wall: stricture and we perform ureteroplasty(Lap BMG augment for longer stricture) and we can get prostatic urethral stenosis usually at the beginning (BNO) or end of prostatic urethra( Trauma) and needs urethroplasty.Ureteric obstruction due to Retro Peritoneal Fibrosis(RPF) and we do not enter the ureter, Prostatic obstruction is outside the urethra and as a urethra surgeon I would request my friends not to destroy prostatic urethra. The Future of BPH surgery is Urethra Preserving. Prof Venugopal has posted photos of 3 new procedures where the results of these techniques look promising. View DocumentView DocumentView Document