Enucleation vs. Resection: A Matched-pair Analysis of TURP , HoLEP and Bipolar TUEP in Medium-sized Prostates

Magistro, Giuseppe; Schott, Melanie; Keller, Patrick; Tamalunas, Alexander; Atzler, Michael; Stief, Christian G. und Westhofen, Thilo (2021): Enucleation vs. Resection: A Matched-pair Analysis of TURP , HoLEP and Bipolar TUEP in Medium-sized Prostates. In: Urology, Bd. 154: S. 221-226

Abstract

OBJECTIVE To evaluate efficacy and safety of holmium laser enucleation of the prostate (HoLEP), bipolar enucleation of the prostate (bTUEP) and transurethral resection of the prostate (TURP) in medium-sized prostates (50cc). METHODS We present a retrospective analysis of 2230 patients treated for lower urinary tract symptoms. We analysed perioperative parameters, short-term clinical outcomes and adverse events in matched-pair cohorts. RESULTS Both HoLEP and bTUEP were superior in terms of efficacy compared to TURP (surgery time: 51min and 50min vs. 60min;P < 0.001;tissue retrieval percentage: 71.4% and 70% vs. 50%;P < 0.001) and showed stronger improvement of LUTS (change IPSS: -15 and -14 vs. -10;P = 0.008). Furthermore, urodynamic parameters (Qmax: +15 ml/s and +19 ml/s vs. +12 ml/s;P < 0.001;PVR: -100 ml and -95 ml vs. - 80ml;P < 0.008) were significantly more improved after enucleation than after TURP. All techniques showed an equally low complication rate (6.9% and 6.9% vs. 10.3%;P = 0.743). No relevant difference of clinical outcomes was identified between HoLEP and bTUEP. CONCLUSION Both resection and enucleation are efficient and safe procedures in patients with medium-sized prostates (50cc), but irrespective of the technical approach, transurethral enucleation is superior to TURP in terms of perioperative and functional outcomes. (C) 2021 Elsevier Inc.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 0090-4295
• Sprache: Englisch