Presented by: Jun Hagiuda MD, PhD
Tokyo Dental College, Ichikawa General Hospital

Introduction

Bipolar transurethral enucleation of prostate is one of the useful treatments for large benign prostate hyperplasia (BPH). However, how the outcome changes according to prostate size were rarely elucidated. The aim of this study is to confirm the efficacy and safety regardless of prostate size treated by transurethral enucleation with bipolar (TUEB) in which specially developed TUEB loop was used.

Materials

A total of 211 patients who received TUEB were categorized into two groups depend on prostate size; the small (≤ 80mL) and large prostate volume group (> 80mL). Background and outcome of treatment were compared.

Results

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Operation time (111.5 vs 163.6 minutes), enucleation time (48.3 vs 65.6 min) and morcellation time (11.2 vs 24.4 min) were longer and hemoglobin decreased significantly (0.81 vs 1.33 g/dL) in large BPH group. However, the enucleation efficiency (0.71 vs 1.00 g/min), Prostate Specific Antigen reduction rate (26.0 vs 16.0 %) and catheterization time (2.89 vs 2.68 days) were significantly better in large BPH group with similar enucleation rate (81 vs 78 %). International Prostate Symptom Score, maximum flow rate of uroflowmetry and post void residual urine were improved at 3-, 6-, and 12 months compared with baseline in both groups. No one has received blood transfusion. There was no difference in frequency of postoperative clot retention, urethral stricture, stress incontinence at 3- 6- and 12 months.

Conclusion

Transurethral enucleation with bipolar using TUEB loop showed higher enucleation efficiency, efficacy and safety for BPH surgery regardless of prostate size. TUEB would be considered as one of the best options for large BPH treatment which is uncontrollable under medication.

Funding

none

Co-Authors

Tsukasa Masuda,
Tokyo Dental College, Ichikawa General Hospital

Ryohei Takahashi,
Tokyo Dental College, Ichikawa General Hospital

Satoshi Tamaki,
Tokyo Dental College, Ichikawa General Hospital

Ken Nakagawa,
Tokyo Dental College, Ichikawa General Hospital