Bipolar transurethral enucleation and resection of the prostate versus bipolar transurethral resection of the prostate for prostates larger than 80 g: Comparison of early postoperative outcome

Abstract

Aim The aim of the present study was to compare the safety and early postoperative outcomes of bipolar transurethral enucleation and resection of the prostate (TUERP) and transurethral resection of the prostate (TURP) in patients with prostates larger than 80 g. Patients and Methods Between January 2014 and December 2016, 41 and 61 patients had bipolar TUERP and bipolar TURP performed at our unit for the treatment of prostates larger than 80 g. All patients were evaluated preoperatively by digital rectal examination, transrectal ultrasonography and laboratory studies, including measurement of haemoglobin and prostate‐specific antigen levels. Patients were reassessed postoperatively at 3 months. Results The preoperative parameters between bipolar TUERP and TURP were comparable. Bipolar TUERP is more efficient in tissue removal, with more tissue retrieved per minute of theatre time (0.73 g/min vs 0.64 g/min, P = 0.022). The hospitalization time between the groups was comparable. Bipolar TUERP achieved a lower serum prostate‐specific antigen level (1 ng/mL vs 1.8 ng/mL, P < 0.001), lower transrectal ultrasonography volume (18.3 cm3 vs 23.8 cm3, P < 0.001) and higher peak flow rate (23.1 mL/s vs 16.9 mL/s, P = 0.026) compared with bipolar TURP at 3 months postoperatively. Postoperative complications due to urinary tract infection were more common in the bipolar TURP group, while the readmission rate due to transient haematuria was higher among bipolar TUERP patients. The transfusion rate was low in both groups, and postoperative urethral stricture was uncommon. Conclusions Bipolar TUERP is a safe technique for the surgical treatment of large prostates. More complete removal of adenoma can be achieved without an increase in theatre time. Bipolar TUERP results in better early postoperative functional outcomes in terms of higher peak flow rate compared with bipolar TURP. The complication rate is not increased with bipolar TUERP.