You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy and New Technology II1 Apr 20122020 TRANSURETHRAL ENUCLEATION WITH BIPOLAR SYSTEM VERSUS OPEN PROSTATECTOMY FOR LARGE PROSTATES GREATER THAN 70 CC Yosuke Hirasawa, Hiroki Ide, Yujiro Ito, Katsura Hoshino, Atsuko Sato, Hiroshi Hongo, Yasumitsu Uchida, and Takeshi Masuda Yosuke HirasawaYosuke Hirasawa Saitama, Japan More articles by this author , Hiroki IdeHiroki Ide Saitama, Japan More articles by this author , Yujiro ItoYujiro Ito Saitama, Japan More articles by this author , Katsura HoshinoKatsura Hoshino Saitama, Japan More articles by this author , Atsuko SatoAtsuko Sato Saitama, Japan More articles by this author , Hiroshi HongoHiroshi Hongo Saitama, Japan More articles by this author , Yasumitsu UchidaYasumitsu Uchida Saitama, Japan More articles by this author , and Takeshi MasudaTakeshi Masuda Saitama, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2183AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Transurethral enucleation with bipolar system (TUEB) is a transurethral procedure that uses a spatula attached to a standard tungsten wire loop to dissect whole prostatic lobes off of the surgical capsule, while maintaining excellent hemostasis for surgically managing benign prostatic hyperplasia (BPH). This is the first study to attempt to determine whether TUEB could be an alternative to open prostatectomy (OP) in patients with a large prostate > 70 cc. METHODS We performed a retrospective analysis of 60 patients with lower urinary symptoms secondary to BPH with an enlarged prostate (>70 cc) who underwent TUEB or OP. There were 30 patients in each group. All patients were assessed preoperatively using the International Prostate Symptom Score (IPSS), Quality of Life Score (QOL), and complete urodynamic evaluation. Perioperative parameters such as blood loss, catheter removal, and hospital stay were assessed. Early and late complications were recorded. Patients were evaluated at 12-month follow-up with the same tests. RESULTS There was no significant difference between the TUEB and OP groups in terms of age, preoperative IPSS, QOL, peak urinary flow rate, postvoiding residual volume (PVR), prostate volume (TUEB: 99.4 cc [range 70.9-184.7 cc] vs OP: 98.3 cc [range 71.7-200.8 cc], p=0.872), or weight of resected tisssue (TUEB: 60.3 g [range 40.0-97.0 g] vs OP: 66.4 g [range 20.8-127.7 g], p=0.315). There were significant differences in mean hemoglobin loss (TUEB: 1.4 g/dL vs OP: 2.4 g/dL, p=0.035), median catheter time (TUEB: 44.5 hours vs OP: 121.2 hours, p=0.025), median hospital stay (TUEB: 5 days vs OP: 8 days, p=0.047), and mean operative time (TUEB: 151 minutes vs OP: 91 minutes, p=0.026). Both TUEB and OP resulted in postoperative improvements in IPSS (TUEB: 8.5 vs OP: 8.4, p=0.95), QOL (TUEB: 1.6 vs OP: 1.7, p=0.84), peak urinary flow rate (TUEB: 19.6 ml/s vs OP: 21.5 ml/s, p=0.363), and PVR (TUEB: 24.9 ml vs OP: 19.7 ml, p=0.430). Blood transfusions were required in 1 TUEB patient vs 6 OP patients. There were no severe early complications, including death, in either group. Late complications were also comparable in both groups. CONCLUSIONS TUEB and open prostatectomy were equally effective for relieving obstruction and lower urinary tract symptoms for large prostate glands (>70 cc). TUEB entails significantly less blood loss and a much shorter catheter time and hospital stay. The rate of late complications was equally low with each procedure. TUEB appears to be a safe and attractive endourologic alternative to open prostatectomy for large prostate glands. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e815 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Yosuke Hirasawa Saitama, Japan More articles by this author Hiroki Ide Saitama, Japan More articles by this author Yujiro Ito Saitama, Japan More articles by this author Katsura Hoshino Saitama, Japan More articles by this author Atsuko Sato Saitama, Japan More articles by this author Hiroshi Hongo Saitama, Japan More articles by this author Yasumitsu Uchida Saitama, Japan More articles by this author Takeshi Masuda Saitama, Japan More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...