Comparative Analysis between Transurethral Enucleation with Bipolar and Holmium Laser Enucleation of the Prostate for Benign Prostatic Hyperplasia: Consecutive Case

Abstract

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.