Bipolar Plasma Enucleation of the Prostate (B-TUEP) in Benign Prostate Hypertrophy Treatment: 3-Year Results

摘要

Objective To investigate numerous endoscopic techniques that have been described for the treatment of benign prostate enlargement. Plasma-button enucleation of the prostate (B-TUEP) is a successful treatment option because the large surface creates a fast enucleation process, vaporization, and concomitant hemostasis. The aim of this study was to evaluate the efficacy of bipolar button electrode transurethral adenoma enucleation (B-TUEP) in saline solution. The second end point was to determine the change of International Prostate Symptom Score (IPSS), post-void residual urine, International Index of Erectile Function, transrectal ultrasound gland volume evaluation, and prostate-specific antigen. Materials and Methods Between July 2011 and March 2012, 50 consecutive patients underwent B-TUEP in our facility, all performed by a single surgeon (R.G.). All patients were preoperatively assessed with maximum urinary flow rate, single-question quality of life assessment, IPSS and the International Index of Erectile Function questionnaires, transrectal ultrasound gland volume evaluation, prostate-specific antigen, and post-void residual urine. Results We observed a significant improvement at 12, 24, and 36 months in terms of maximum urinary flow rate (22.3?±?4.74?mL/s, 23.2?±?0.30?mL/s, and 23.6?±?1.26?mL/s, respectively, P ?.01) and quality of life (5.28?±?0.97, 5.69?±?0.90, and 5.73?±?0.87). IPSS and IEEF scores improved significantly ( P ?.05). Gland volume evaluation and post-void residue decreased ( P ?.001). The prostate-specific postoperative antigen levels were 0.76?±?0.61?ng/mL, 0.7?±?0.51?ng/mL, and 0.62?±?0.18?ng/mL, at 12, 24, and 36 months, respectively. Two patients (4%) had persistent bladder outlet obstruction requiring reoperation. Conclusion After 3-year follow-up, B-TUEP represents an effective, durable, and safe form of surgical intervention. B-TUEP is an alternative treatment for symptomatic benign prostate enlargement.