Presented by: Yuki Endo MD, PhD
Nippon Medical School

Introduction

Transurethral resection of the prostate has been the standard surgical treatment for benign prostatic hyperplasia (BPH). We previously reported that Transurethral Enucleation by Bipolar (TUEB) is a comparable and safe alternative to TURP for managing BPH, including patients with large prostate volumes (PV) exceeding 80ml. However, limited data exists regarding the long-term efficacy of TUEB. In this study, we aimed to analyze the efficacy of TUEB over a 24-month follow-up period.

Materials

We retrospectively examined 60 patients with medication-resistant BPH who underwent TUEB at our institution between 2017 and 2022. Preoperative and postoperative assessments included the international prostate symptom score (IPSS), quality of life score (QoLs), uroflowmetry (Qmax), Overactive Bladder Symptom Score (OABSS), Nocturia Score (Nocs), and serum prostate-specific antigen (PSA) levels. Data were collected at various time points up to 24 months postoperatively. Statistical analysis was performed using the chi-square test and Student's t-test.

Results

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All patients had sufficient data available for analysis. Baseline measurements showed a mean IPSS of 17.5, QoLs of 5.0, Qmax of 8.5 mL/s, OABSS of 5.0, and Nocs of 2.0. At 24 months postoperatively, significant improvements were observed in several parameters: mean IPSS decreased to 3.0, QoLs improved to 0.5, Qmax increased to 23.7 mL/s, and OABSS decreased to 2.0. However, there was no significant improvement in Nocs, which remained at 2.0. Median PSA levels decreased by 92.2% at 12 months postoperatively. Prostate cancer was detected in 5 (7%) patients, and 3 (4%) patients experienced postoperative urethral strictures requiring bougie dilation.

Conclusion

The efficacy of TUEB remained consistent over the 24-month follow-up period. TUEB proved to be an effective. The improvements in symptoms, quality of life, and uroflowmetry parameters were sustained throughout the follow-up period. Furthermore, TUEB demonstrated effectiveness in managing overactive bladder symptoms, which persisted for 24 months. However, the occurrence of prostate cancer and postoperative urethral strictures highlights the need for appropriate monitoring and management during the postoperative period.

Funding

no funding

Lead Authors

Jun Akatsuka, MD, PhD
NIppon Medical School

Yuka Toyama, MD, PhD
Nippon Medical School

Go Kimura, MD, PhD
Nippon Medical School

Hayato Takeda, MD
Nippon Medical School

Hiroya Hasegawa, MD
Nippon Medical School

Hikaru Mikami, MD
Nippon Medical School

Mikio Shibasaki, MD
Nippon Medical School

Ryota Funato, MD
Nippon Medical School

Shogo Miyauchi, MD
Nippon Medical School

Mami Taniuchi, MD
Nippon Medical School

Co-Authors

Honami Kishi, MD
Nippon Medical School

Yukihiro Kondo, MD, PhD
Nippon Medical School