Does prostate size count with bipolar transurethral enucleation of the prostate in patients with benign prostatic hyperplasia?

The authors examined the relationship between prostate size and surgical outcomes following bipolar transurethral enucleation of the prostate (B-TUEP). The authors found that B-TUEP provided symptom relief regardless of prostate size in men with benign prostatic hyperplasia (BPH).

BPH is the non-cancerous increase in the size of the prostate gland. BPH can cause symptoms such as frequent urination, trouble starting to urinate, and a weak stream while urinating. Other symptoms include being unable to pass urine or loss of bladder control. This happens because the increased prostate tissue blocks urine flow through the urethra (the tube that passes urine out from the bladder). 

B-TUEP is the use of electrical currents to remove enlarged prostate tissue. It is recommended as the first line treatment in men with larger prostate sizes (over 80 mL). However, it is not known if this procedure is as effective in men with smaller prostates.

There were 172 patients with BPH analyzed for this study. Patients were grouped depending on the size of their prostate. Group 1 included patients with prostates of 60mL or smaller. Group 2 included those with prostates of 61-110mL and group 3 included patients with prostates larger than 110mL. Patients were followed up for 3 months. 

The time patients spent in surgery increased in patients with a larger prostate size. The effectiveness of B-TUEP was higher in men with a prostate size of >110mL. However, the length of hospital stay, the time a catheter (tube in the bladder) was kept in, rates of complications were similar between groups.

Urinary symptoms improved at 1- and 3-month follow-ups in all groups. Sexual symptoms were similar between groups at each follow-up assessment. 

The authors found that B-TUEP provided symptom relief for patients with BPH regardless of prostate size.

This study was carried out in a single surgical center, by a single surgeon. This may influence the results of the study and larger studies across different centers are required to validate this study.