Transurethral Bipolar Enucleation of the Prostate

Abstract

Introduction:

Transurethral bipolar enucleation (TuBE) of the prostate is a novel procedure being utilized for the treatment of benign prostatic hyperplasia (BPH) and its sequela. We hypothesize that TuBE will produce excellent results for patients in urinary retention, as evidenced by their ability to void, post-void residual volumes (PVRs), International Prostate Symptom Score (IPSS) total, and quality of life (QOL) scores.

Materials and Methods:

A retrospective database analysis was used to identify early 6-week postoperative outcomes after TuBE. Inclusion criteria for this analysis included patients in urinary retention, defined by an episode of urinary retention requiring catheterization or PVRs>250 mL with formation of bladder stones or recurrent urinary-tract infections. A comparison was made between preoperative and postoperative factors. The prostate size was measured using transrectal ultrasound. Fisher's exact test was used to compare categorical data and Student's t-test to compare continuous data.

Results:

Thirteen patients were included in the analysis. Two had an indwelling catheter and the remainder were on intermittent catheterization. One patient had bladder stones and one had recurrent infections. All patients in retention preoperatively (N=13) were no longer in retention postoperatively (p<0.01). The change in mean PVRs was −307 mL (premean=351 mL and postmean=44 mL, p<0.01). Thirty-two percent of the preoperative prostate volume (mean=57 g) was enucleated (mean=18 g). The total IPSS score change preoperatively to postoperatively was −11.07 points (premean=19.92, postmean=8.85, p=0.02). The IPPS QOL score change preoperatively to postoperatively was −2.85 points (premean=4.4, postmean=1.55, p<0.01). Two patients had urinary-tract infections, and one patient had meatal stenosis requiring urethroplasty postoperatively.

Conclusions:

TuBE is a novel procedure utilizing common equipment to urologic practices that produces acceptable results for patients in urinary retention, secondary to BPH.

No competing financial interests exist.

Runtime of video: 7 mins 25 secs