A prospective study comparing bipolar endoscopic enucleation of prostate with bipolar transurethral resection in saline for management of symptomatic benign prostate enlargement larger than 70 g in a matched cohort

• Published in: International urology and nephrology Vol. 46; no. 3; pp. 511 - 517
• Main Authors: Kan, Chi Fai, Tsu, Hok Leung, Chiu, Yi, To, Hoi Chu, Sze, Bonnie, Chan, Steve Wai Hee
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer Netherlands 01.03.2014; Springer Nature B.V
• Subjects: Aged; Aged, 80 and over; Endoscopy; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Nephrology; Organ Size; Prospective Studies; Prostatectomy - methods; Prostatic Hyperplasia - pathology; Prostatic Hyperplasia - surgery; Sodium Chloride; Transurethral Resection of Prostate - methods; Urology; Urology - Original Paper; BPH; Transurethral resection in saline; Prostate; Bipolar endoscopic enucleation of the prostate
• ISSN: 0301-1623; 1573-2584
• DOI: 10.1007/s11255-013-0546-4

Purpose This study aims to compare the efficacy and safety of bipolar endoscopic enucleation of prostate with transurethral resection in saline for large BPE greater than 70 g. Methods All patients from two urology centres who had bipolar enucleation or bipolar resection performed for large BPE greater than 70 g from December 2008 to April 2012 were prospectively assessed. The pre-operative and post-operative measures included IPSS, QOL score, uroflowmetry results, PSA and prostate volume. The perioperative measures were compared, and the post-operative complications/resumption of medical treatment for lower urinary tract symptoms were also assessed. Results There were 74 and 86 consecutive patients with bipolar enucleation and bipolar resection performed, respectively. No difference in pre-operative characteristics was observed between the two groups with mean prostate size 115 cc in each group. Comparing bipolar enucleation with bipolar resection, there was longer operative time (156 vs 87 min, p  = 0.000), more haemoglobin drop (1.8 vs 1.1 g/dL, p  = 0.006), but more prostate tissue resected (61.4 vs 45.7 g, p  = 0.000). There was no difference in overall transfusion requirement and hospital stay. At 12 month after the procedure, patients with bipolar enucleation performed had better IPSS (6.4 vs 11.6, p  = 0.032), QOL (1.7 vs 2.6, p  = 0.040) and peak flow rate (19.5 vs 15.1 ml/s, p  = 0.019). The post-operative complications had no significant difference between the two groups. Conclusions For surgical treatment of big BPE, bipolar endoscopic enucleation of prostate provided superior functional outcome than bipolar resection but required longer operative time.