Purpose:This study was conducted to compare the short term clinical efficacy and complications of photoselective vaporization for benign prostatic hyperplasia (BPH), which was classified by the prostate size. Materials and Methods:The clinical data of 309 men with BPH, who had undergone photoselective vaporization for prostate (PVP) using potassium-titanyl-phosphate (KTP) laser, between January 2005 and December 2006, were retrospectively analyzed. All patients were classified into three groups by their prostate size (＜40cc; group I, 40-60cc; group II, ＞60cc; group III). The clinical efficacy of each group was compared in terms of the International Prostate Symptom Score (IPSS), quality of life (QoL) index, changes in the maximum urinary flow rate (Qmax), postvoid residual urine (PVR), complications and postoperative outcomes. The mean follow-up period was 6.4 months. Results: The postoperative parameters were significantly improved in all patients (p＜0.05). With respect to each of the three classified groups, the postoperative parameters of each group were also significantly improved (p＜0.05). However, in group III, the postoperative IPSS and QoL index were lower than the average value. Especially, the items for frequency, nocturia and urgency of the IPSS resulted in bad grades. The rate of complications in group III were higher than those in groups I and II, such as urinary retention, delayed hematuria, urethral stricture and bladder neck contracture. Conclusions: Despite the excellence of KTP, careful consideration must be given when the operation is performed on patients with a large prostate size. (

Background: Three-quarters of aged men experience lower urinary tract symptoms with benign prostate hypertrophy (BPH). Transurethral resection of the prostate (TURP) and holmium laser enucleation of the prostate (HoLEP) are standard endosurgical procedures in patients with BPH. Previous studies reported better results in patients undergoing HoLEP than in those undergoing TURP. Methods: This study compared the efficiency and safety of conventional morcellation and morcellation performed after X-incision during enucleation, a newly added technique in HoLEP. Overall, 174 patients were selected as the final study population. The populations were stratified with respect to resected volumes. A t-test were used to compare the conventional morcellation and X-incision procedure groups. Results: In morcellation times and rates, there were significant differences in stratified resected mass (g) between the groups. The results also showed a decreased incidence of bladder injury as a surgical complication. Conclusion: We believe morcellation performed after X-incision procedure during enucleation is efficient and safe for older adults with BPH.

Background: This retrospective study examined the safety and efficacy of transurethral enucleation with bipolar energy (TUEB) for benign prostatic hyperplasia (BPH), based on initial experiences. Methods: In this study, 2 surgeons performed TUEB on 23 patients between January 2014 and April 2017. The International Prostate Symptom Score (IPSS), quality of life (QoL), digital rectal examination, transrectal ultrasonography, prostate-specific antigen (PSA) levels, maximum flow rate (Qmax), and postvoid residual urine (PVR) were used as variables. Resected prostate volume (g), resection time, efficiency of resection, change in hemoglobin, and indwelling Foley catheter duration were used to assess the efficacy of TUEB. Foley catheter reinsertion rate, occurrence of urethral or bladder neck stricture, urinary incontinence, and bladder injury were evaluated as complications of TUEB. Results: Mean age was 70.3±8.3 years. Mean prostate volume was 55.1±33.9 g. Preoperative and 1-month postoperative PSA, IPSS, QoL, Qmax, and PVR data were collected and showed significant difference. Resected prostate volume, resection time, resection efficiency, indwelling Foley catheter duration, and change in hemoglobin values were 22.9±14.7 g, 109.6±60.3 minutes, 0.23±0.13 g/min, 4.7±4.7 days, and 0.9±0.7 g/dL, respectively. Following TUEB, incontinence occurred in 2 patients and acute urinary retention in 2 (8.7%). Conclusion: Our initial experience suggests that TUEB is efficient and safe for patients with BPH. However, the study was limited by the small number of subjects.

Background:The study aimed to compare the efficiency and safety of transurethral enucleation with bipolar (TUEB) and holmium Laser enucleation of the Prostate (HoLEP) in patients with benign prostatic hyperplasia (BPH). Method:The study was retrospectively analyzed with 132 patients who underwent TUEB (n=53) and HoLEP (n=79) between May 2017 and December 2021. To evaluate the changes of pre-and postoperative urinary symptoms, we measured the peak flow rate (Qmax, mL/s), post-voided residual volume (PVR, mL) and International Prostate Symptom Score (IPSS). In addition, we statistically conducted the resected weight (g), resection time (min), resection efficiency (g/min) by the prostate weight into ＜50, 50-80 and ＞80 g groups. The urinary catheter reinsertion, urinary tract infection, bladder neck contracture, incontinence, bladder injury and change in hemoglobin correlated with postoperative complications were analyzed. Results:The mean age was 71.0±7.4 years for TUEB group and 71.4±7.4 years for HoLEP group. Prostate resected weight, resection time, and resection efficiency were 46.9±22.1 g, 59.6±30.9 min, 0.81±0.11 g/min in TUEB group respectively and were 49.7±25.9 g, 46.7±25.9 min, 0.79±0.12 g/min in HoLEP group respectively. The resection efficiency had better outcome in TUEB group (0.86±0.12 g/min) than that of HoLEP group (0.67±0.08 g/min) in Subgroup 1 (prostate weight ＜50 g). In both group, there was pronounced improvement in the IPSS, Qmax and PVR at 3 months after surgery. Any patient was not needed for blood transfusion. Conclusion:Our study suggested that TUEB was not inferior to HoLEP in resection efficiency and postoperative outcome. Also, it may be the best consideration for surgical treatment with BPH patients, especially those with a prostate less than 50 g.

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