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A prospective, randomised trial comparing transurethral enucleation with bipolar system (TUEB) to monopolar resectoscope enucleation of the prostate for symptomatic benign prostatic hyperplasia

Objective: To compare the clinical outcomes between Transurethral Enucleation with Bipolar system (TUEB) and monopolar resectoscope enucleation of the prostate (mTUEP) for treating Benign Prostatic Hyperplasia (BPH) in a prospective randomized trial with 12 months of follow-up.

Methods: The study randomized 114 consecutive patients with BPH into either a TUEB (n=59) or mTUEP (n=55) treatment group.

Results: Significant differences were seen in the resection weight per unit time (0.76 ± 0.14 vs. 0.82 ± 0.23 g/min, P=0.04) and blood glucose levels (6.20 ± 1.35 vs. 5.34 ± 1.32 mmol/L, P=0.00) perioperatively, favoring TUEB over mTUEP. Patients in the mTUEP group showed statistically significant increases in postoperative blood glucose compared with their preoperative baseline (5.63 ± 1.54 vs. 6.20 ± 1.35 mmol/L, P=0.04), but still within normal limits. There was no statistically significant difference in operative time, intraoperative blood loss, resection rate, or serum sodium and haemoglobin levels.

Conclusion: TUEB was shown to be a safe and highly effective technique for relief of Bladder Outlet Obstruction (BOO). The clinical efficacy of TUEB is sustainable for up to 1 year of follow-up. Our single-center results show that TUEB has the same efficacy as monopolar TUEP for the surgical treatment of symptomatic BPH, which is potentially associated with a low rate of complications and a high efficiency of enucleation.

Author(s): Zhenlong Wang, Hecheng Li, Tie Chong