Bipolar Transurethral Enucleation of the Prostate: Is it a size-independent endoscopic treatment option for symptomatic benign prostatic hyperplasia?

• Published in: PloS one 2021-06, Vol.16 (6), p.e0253083-e0253083
• Main Authors: Bebi, Carolina, Turetti, Matteo, Lievore, Elena, Ripa, Francesco, Rocchini, Lorenzo, Spinelli, Matteo Giulio, De Lorenzis, Elisa, Albo, Giancarlo, Longo, Fabrizio, Gadda, Franco, Dell'Orto, Paolo Guido, Salonia, Andrea, Montanari, Emanuele, Boeri, Luca
• Format: Article
• Language: English
• Subjects: Algorithms; Biology and Life Sciences; Bladder; Body mass; Body mass index; Body size; Catheterization; Catheters; Comorbidity; Complications and side effects; Direct reduction; Enucleation; Genital diseases; Holmium; Hyperplasia; Hypertrophy; Intubation; Lasers; Medicine and Health Sciences; Methodology; Patient outcomes; People and Places; Postoperative period; Prostate; Prostatectomy, Transurethral; Questionnaires; Reductases; Surgeons; Surgery; Surgical outcomes; Thulium; Tumors; Urology
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0253083

Bipolar Transurethral Enucleation of the Prostate (B-TUEP) is recommended as a first-choice treatment for benign prostatic obstruction in prostates >80 ml. Differently, B-TUEP is only considered as an alternative option after TURP for smaller prostates (30-80 ml). The aim of our study is to assess the relation between prostate size and surgical outcomes after B-TUEP. We performed a retrospective analysis of data collected from 172 patients submitted to B-TUEP. Patients were segregated according to tertiles of prostate volume (PV) ([less than or equal to]60 ml, 61-110 ml, >110 ml). For each group we evaluated enucleation efficacy (enucleated weight/enucleation time), complication rates, urinary and sexual function parameters. Functional and sexual parameters were compared between groups at baseline, 1 and 3 months follow up. Descriptive statistics and linear and logistic regression models tested the association between PV and postoperative complications/outcomes. Operative time and weight of enucleated adenomas increased along with prostate volumes (all p[less than or equal to]0.01). Enucleation efficacy was higher in men with PV >110 ml compared to other groups (p[less than or equal to]0.001). Length of hospital stay, catheterization time and rates of postoperative complications, such as transfusion and clot evacuation rates and bladder neck/urethral strictures, were comparable between groups. Urinary symptoms improved at 1-and 3-months in each group as compared to baseline evaluation (all p