Comparing B-TUERP versus B-TURP surgery for patients with large prostates

This study compared bipolar transurethral enucleation and resection of the prostate (B-TUERP) with bipolar transurethral resection of the prostate (B-TURP) to assess which was more effective and safer for patients with enlarged prostates. The authors concluded that B-TUERP was safer and more effective than B-TURP for these patients.

In benign prostatic hyperplasia (BPH), the prostate is enlarged and presses on the bladder. This can cause urination problems that affect a patient's quality of life. BPH can be treated by surgically removing the prostate. In transurethral resection of the prostate (TURP) surgery, a thin tube with a cutting tool is inserted through the urethra to cut and remove the prostate.

TURP surgery is effective for most patients, but it can cause other health complications. B-TURP is one improvement to TURP surgery that uses fluid to reduce the effects of surgery on the patient.  B-TUERP is similar but removes extra prostate tissue using a less intrusive method. Whether B-TUERP is safer and more effective than B-TURP for patients with BPH is under investigation.

This study had 240 patients with BPH. Patients were divided into two groups. The first group underwent B-TUERP surgery (120 patients) and the second group underwent B-TURP surgery (120 patients).  The effectiveness and side effects experienced by patients were recorded for 2 years.

The average length of time of the operation was longer for B-TUERP (105.09 minutes) than B-TURP (61.09 minutes). However, more prostate tissue was removed with B-TUERP (50.41 g) than B-TURP (41.12 g). Patients who had B-TUERP had a significantly shorter hospital stay after surgery compared to patients who had B-TURP surgery (52.53 hours vs. 60.41 hours).

International prostate symptom scores measure a patient’s BPH symptoms. In the B-TUERP group, scores decreased from 29 to 6. In the B-TURP group, scores decreased from 30 to 7. After surgery, the amount of urine left in patients' bladders also decreased. B-TUREP surgery showed the biggest difference (from 303.76 mL to 18.64 mL) compared to B-TURP surgery (from 289.3 mL to 24.74 mL).

There were no differences in side effects between the two surgeries. Patients' hemoglobin levels dropped by 1.5 g/dL after B-TUERP surgery versus 2 g/dL after B-TURP surgery. Slightly more patients in the B-TUREP group experienced urethral stricture (narrowing of the tube that passes urine) compared to B-TURP (0.9% vs. 0%).

This study concluded that B-TUERP surgery improved BPH symptoms in patients more than B-TURP surgery. No significant differences in side effects were observed between the two surgeries.

This study had a small number of patients and a short follow-up period (2 years). Larger studies with a longer follow-up are needed to confirm these results.

Talk to your doctor about improvements in TURP surgery that may benefit your treatment.