Evolving Transurethral Resection of the Prostate: Enucleation-Resection of the Prostate

Galanakis, Ioannis P.; Celia, Antonio; Biondo, Dario Del; Zeccolini, Gugleilmo; A, Caruso; Silvestre, Pasquale; Giunta, Angelo Di; Breda, G.

doi:10.1089/end.2010.0300

Cited by 7 publications

(5 citation statements)

References 14 publications

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“…From this perspective, detachment of residual adenoma tissue secondary to monopolar TURP was performed with a detaching blade . Additionally, standard resection was at some point altered into an enucleation–TURP procedure, during which the conventional endoscopic stages were completed with a bipolar resectoscope‐based HoLEP‐like technique . Furthermore, the transurethral detachment prostatectomy involving the use of a prostate‐detaching blade and resectoscope tip was followed by BPH tissue morcellation .…”

Section: Discussionmentioning

confidence: 99%

Bipolar plasma enucleation of the prostate vs open prostatectomy in large benign prostatic hyperplasia cases – a medium term, prospective, randomized comparison

et al. 2013

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What's known on the subject? and What does the study add?• According to the EAU Guidelines 2012, large size benign prostatic hyperplasia (BPH) cases (>80 mL) continue to have open prostatectomy as the first line treatment alternative, despite the substantial peri-operative morbidity and extended catheterization and convalescence periods related to this undoubtedly invasive approach. During the past two decades, holmium laser enucleation of the prostate was constantly described as a successful choice for this category of patients. According to rather numerous studies, the technique displayed superior results in terms of surgical safety and postoperative recovery compared with the open procedure. On the other hand, the concept of electrosurgical enucleation of the prostate, using either a monopolar or bipolar cutting current, materialized into several technical applications that eventually failed to gain general acknowledgement as reliable alternatives to the BPH transurethral approach.• While keeping in mind the already proved advantage of enucleating substantial quantities of BPH tissue, bipolar plasma enucleation of the prostate was introduced as a novel endoscopic approach in cases of large prostates. The present trial represents the first prospective, medium-term, randomized comparison to be published of this innovative technique with standard open prostatectomy. Basically, the premises for a viable alternative relied on the practical advantages provided by the 'button' electrode, mainly the large surface creating the conditions for a fast enucleation process, continuous vaporization and concomitant haemostasis. Eventually, it was concluded that the plasma enucleation procedure distinguished itself as a successful treatment option in large BPH patients, characterized by good surgical efficiency, significantly reduced complications, faster postoperative recovery, similar prostatic tissue ablation capabilities and satisfactory follow-up results compared with the open technique. Most importantly, plasma-button enucleation patients benefited from a similar 12 months' outcome from the perspectives of symptom scores and voiding parameters when drawing a parallel with open surgery results, thus underlining the reliable viability of this type of endoscopic approach. Objectives• To evaluate the viability of bipolar plasma enucleation of the prostate (BPEP) by comparison with open transvesical prostatectomy (OP) in cases of large prostates with regard to surgical efficacy and peri-operative morbidity.• To compare the medium-term follow-up parameters specific for the two methods. Patients and Methods• A total of 140 benign prostatic hyperplasia (BPH) patients with prostate volume >80 mL, maximum flow rate (Qmax) <10 mL/s and International Prostate Symptom Score (IPSS) >19 were randomized in the two study arms.• All cases were assessed preoperatively and at 1, 3, 6 and 12 months after surgery by IPSS, Qmax, quality of life score (QoL) and post-voiding residual urinary volume (PVR).• The prostate volume and prostate speci...

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Section: Discussionmentioning

confidence: 99%

Bipolar plasma enucleation of the prostate vs open prostatectomy in large benign prostatic hyperplasia cases – a medium term, prospective, randomized comparison

et al. 2013

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“…The bipolar enucleation and resection of prostate is a minimally invasive approach, which renders complete adenoma removal and, as such, provides unique advantages over other surgical modalities for BPH. Recently, a number of reports have been published on the bipolar enucleation of enlarged prostates, which assessed the safety and durability of this procedure [1][2][3][4] . Among these studies, the report of Liu et al [2] is the biggest study to date that provides evidence on the long-term efficacy and safety of bipolar enucleation of prostates.…”

Section: Discussionmentioning

confidence: 99%

“…Plasmakinetic transurethral enucleation and resection of the prostate (TUERP) was introduced in China in 2003 [1][2][3] . Its efficiency, safety and durability have recently been documented [2,4] . However, the widespread acceptance of bipolar TUERP has been slow because of the perception of technical difficulty, which has a steep and long learning curve compared with the gold reference TURP.…”

Section: Introductionmentioning

confidence: 99%

Learning Curve for Bipolar Transurethral Enucleation and Resection of the Prostate in Saline for Symptomatic Benign Prostatic Hyperplasia: Experience in the First 100 Consecutive Patients

Xiong¹,

Sun

Qing³

et al. 2012

Urol Int

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Background: Bipolar transurethral enucleation and resection of the prostate in saline has recently been considered as a safe and technically feasible endoscopic procedure for symptomatic benign prostatic hyperplasia. However, it has not been accepted widely because of the perception of technical difficulty. Methods: A retrospective data review was performed of the first consecutive 100 patients who had undergone bipolar transurethral enucleation and resection of prostatic adenoma. Operative outcome, complications, ratio of conversion to conventional transurethral resection of the prostate and efficiency of tissue enucleation and resection were used to assess the learning curve. Results: Bipolar transurethral enucleation and resection of the prostate was successfully performed in 83 patients. The mean operative time was 117.5 min, and the mean indwelling catheterization was 3.3 ± 1.9 days. After 6 months, maximum urinary flow was 21.34 ± 4.09 ml/s, IPSS was 9.66 ± 2.64, and quality of life was 2.31 ± 0.92 with a residual prostate volume of 35.29 ± 17.57 ml. Regarding the learning curve, the ratio of conversion to conventional bipolar transurethral resection of the prostate decreased after 30 cases, and the efficiency of enucleation and resection increased significantly with accumulative experience after 50 cases. Conclusions: The current results established that bipolar transurethral enucleation and resection of the prostate in saline is a safe and reproducible procedure.

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“…16 However, a standard technique for this procedure is not yet established as it may remain both technically challenging and difficult to learn. 17 Based on these premises, the present trial was designed to reach toward a premiere clinical analysis among the literature data while evaluating a single-center, prospective, randomized controlled comparison concomitantly involving all three types of endoscopic approaches as well as the standard simple OP.…”

Section: Bipolar Versus Open Surgery In Large Prostatesmentioning

confidence: 99%

Bipolar Vaporization, Resection, and Enucleation Versus Open Prostatectomy: Optimal Treatment Alternatives in Large Prostate Cases?

Geavlete

Bulai

Ene

et al. 2015

Journal of Endourology

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Evolving Transurethral Resection of the Prostate: Enucleation-Resection of the Prostate

Abstract: The e-TURP seems to be a safe and effective method for the endoscopic management of BPH. Further investigation with randomized trials is needed on this matter.

Cited by 7 publications

References 14 publications

Bipolar plasma enucleation of the prostate vs open prostatectomy in large benign prostatic hyperplasia cases – a medium term, prospective, randomized comparison

Bipolar plasma enucleation of the prostate vs open prostatectomy in large benign prostatic hyperplasia cases – a medium term, prospective, randomized comparison

Learning Curve for Bipolar Transurethral Enucleation and Resection of the Prostate in Saline for Symptomatic Benign Prostatic Hyperplasia: Experience in the First 100 Consecutive Patients

Bipolar Vaporization, Resection, and Enucleation Versus Open Prostatectomy: Optimal Treatment Alternatives in Large Prostate Cases?

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