Comparing safety and effectiveness of bipolar transurethral enucleation and resection in patients with benign prostatic hyperplasia.

This study compared the safety and effectiveness of bipolar transurethral enucleation of the prostate (BipoLEP) to bipolar transurethral resection of the prostate (B-TURP) in the treatment of benign prostatic hyperplasia (BPH). The data showed that BipoLEP resulted in fewer adverse effects, complications, and faster recovery.

BPH is an enlargement of the prostate gland. BPH causes lower urinary tract symptoms due to bladder outlet obstruction.

Transurethral resection of the prostate (TURP) is a gold standard surgical treatment for patients with BPH. However, complications like bleeding and transurethral resection syndrome (TUR syndrome) can occur. TUR syndrome results from fluid absorption following bladder irrigation and can affect serum sodium levels.

A modified TURP procedure, B-TURP, uses normal saline as the irrigation fluid during resection. B-TURP decreases the occurrence TUR syndrome and reduces bleeding. BipoLEP uses a laser to vaporize the extra tissue blocking outlet obstruction of the bladder. It has a low complication rate. However, there is a need to compare the safety and effectiveness of BipoLEP to B-TURP for BPH treatment.

The study included 128 patients with symptoms of BPH. 72 patients were treated with BipoLEP, while 56 patients received B-TURP. Prostate volumes ranged from 80 to 125 mLs. Patients were followed up for 1, 3, and 6 months after the procedure.

Patients treated with BipoLEP had more prostate tissue resected (64.2 g) compared to those treated with B-TURP (52.7 g). The average time spent on continuous bladder irrigation was lower (20.7 hours) for BipoLEP compared to 29.6 hours for B-TURP.

The average time spent with a catheter was also lower (4.3 days) for BipoLEP compared to 5.6 days with B-TURP. Patients who had BipoLEP also spent less time in the hospital (5.2 days) on average compared to B-TURP (6.5 days).

Both groups had significant improvements in urinary symptoms at 3 months. However, there were no significant differences between groups in urinary symptom improvements.

The study suggests that BipoLEP can be safer and similarly effective, with better recovery times compared to B-TURP for patients with BPH.

Serum sodium was not measured in relation to irrigation fluid absorption during the procedures. Data was not available on prostate-specific antigen (PSA; a marker of enlarged prostate) levels.