-Original-

Efficacy and Safety of Transurethral Enucleation with Bipolar Energy for Treatment of Benign Prostatic Hyperplasia: Does Prostate Volume Matter?

Yuki Endo¹, Hiroyuki Shimizu², Jun Akatsuka¹, Shigehito Minaguchi¹, Hiroya Hasegawa¹, Yuka Toyama¹, Yasutomo Suzuki¹, Tsutomu Hamasaki¹, Mamoru Oki³, Jun Hasegawa² and Yukihiro Kondo¹

¹Department of Urology, Nippon Medical School, Tokyo, Japan
²Hasegawa Hospital, Tokyo, Japan
³Seishukai Clinic, Tokyo, Japan

Background: We evaluated the association of prostate volume (PV) with the efficacy and safety of transurethral enucleation with bipolar energy (TUEB) for treatment of benign prostatic hyperplasia (BPH).
Methods: We retrospectively evaluated data from 180 patients with symptomatic BPH who underwent TUEB between 2008 and 2015. Efficacy was assessed by perioperative changes in international prostate symptom score (IPSS), Quality of Life Score (QOLS), maximum flow rate on uroflowmetry (Qmax), and serum prostate-specific antigen level (PSA), which were recorded at 3 months postoperatively. Safety was assessed by perioperative incidence of adverse events (AEs). AEs were recorded up to 2 years after surgery. Patients were divided into two groups based on PV as the standard group (SG; PV < 80 mL) and large group (LG; PV ≥ 80 mL).
Results: A total of 132 (73%) patients were grouped as the SG, and 48 (27%) were grouped as the LG. No significant differences between the groups were observed in the preoperative variables age, IPSS, and QOLS. However, the LG had a significantly larger PV and higher serum PSA levels. Analysis of surgical outcomes revealed that postoperative changes in IPSS, QOLS, Qmax, serum PSA, serum sodium, and hemoglobin levels did not differ significantly between groups. However, LG had a significantly longer operative time and heavier specimen weight. The rates of early complications, including hyponatremia and blood transfusion, and late complications after surgery did not differ between the groups.
Conclusion: The present findings suggest that TUEB is safe and effective for treatment of BPH, regardless of PV.

J Nippon Med Sch 2022; 89: 436-442

Keywords
transurethral enucleation, benign prostatic hyperplasia, transurethral resection, efficacy

Correspondence to
Yuki Endo, MD, PhD, Department of Urology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
y-endo1@nms.ac.jp

Received, October 5, 2020
Accepted, March 23, 2022