Comparison of transurethral enucleation with bipolar and transurethral resection in saline for managing benign prostatic hyperplasia

OBJECTIVE • To illustrate the transurethral enucleation with bipolar (TUEB) technique and compare the efficacy and safety of TUEB and transurethral resection in saline (TURis) for managing benign prostatic hyperplasia (BPH). PATIENTS AND METHODS • A retrospective review of a singleinstitution experience of 110 consecutive TUEB or TURis between 2008 and 2011 at our hospital was performed aiming to compare the efficacy and safety of TUEB and TURis for managing BPH (55 patients in each group). • Peri-operative data included operating time, resected tissue weight, changes in haemoglobin, duration of catheterization, hospital stay and early complications. • Postoperative outcomes included 6-and 12-month postoperative International Prostate Symptom Score (IPSS), and Quality of Life (QoL) score, urofl owmetry findings, change in serum prostate-specific antigen level and all late complications in the two groups. RESULTS • Both groups were well matched for age, preoperative prostate volume, IPSS, QoL and urofl owmetry findings. • The change in haemoglobin at postoperative day 1 in the TUEB group was significantly less than in the TURis group (1.08 vs 1.60 g/dL; P < 0.001). • Catheterization time and hospital stay were significantly shorter in the TUEB group than in the TURis group and the mean retrieved tissue weight in the TUEB group was larger than that in the TURis group (41.3 vs 31.7 g; P =0.007). • Patients in the two arms had comparable improvements in postoperative IPSS, QoL, maximum fl ow rate and postvoid residual urine volume. • The rates of complications were equally low with each procedure. CONCLUSION • TUEB is superior to TURis, with less bleeding, as well as decreased catheter time and hospital stay, although showing equivalent efficacy at 12 months of follow-up.