The Initial Clinical Experience of a New Generation Bipolar Electrosurgical and Morcellator Unit for Bipolar Transurethral Enucleation of the Prostate

Abstract

Background and Objective To assess the feasibility and safety of performing bipolar transurethral enucleation of the prostate (BIPO-LEP) with a new generation of bipolar electrosurgical and morcellator system. Material and Methods Forty-five consecutive patients scheduled for endoscopic surgery for benign prostatic obstruction were pro-spectively recruited. BIPOLEP was performed with the use of the third generation Karl Storz AUTOCON III 400 and morcellator unit. All patients had a trial without a catheter on Day-1 after surgery. Demographical, preoperative, intraoperative and follow-up data up to 3 months post-surgery were collected and analyzed. Results Between May 2018 and April 2019, 45 consecutive patients underwent BIPOLEP in our institution were prospectively recruited for this study. The mean age was 76 years old. Thirty-four patients (75.6%) were in refractory retention or obstructive uropathy. The mean enucleation efficiency was 1.76 grams per minute of enucleation time (SD = 0.7 gram per minute). The mean bladder irrigation and catheterization times were 5.3 hours and 20.7 hours respectively. Only one patient failed voiding trial on Day-1 after surgery. The postoperative Day-1 discharge rate was 73.3% (n = 33). The median length of hospital stay was 1 day. No patient required clot evacuation or blood transfusion. Seven patients (15.6%) were readmitted within thirty days postoperatively for complications, due to hematuria (8.9%, n = 4) and febrile urinary tract infection (6.7%, n = 3). Nevertheless, none was readmitted for acute urinary retention. Conclusion The use of a new generation of bipolar electrosurgical and morcellator unit for BIPOLEP was safe and the majority could be discharged without catheter within one day after surgery.