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Organo Oficial de la Sociedad Mexicana de Urología

2018, Number 5

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Rev Mex Urol 2018; 78 (5)

Bipolar transurethral enucleation in the treatment of obstructive prostatic hyperplasia

Martínez-Alonso IA, Estrada-Carrasco CE, Torres-Gómez JJ, Hernández-Palacios GA, Islas-García JJO, Valdez-Flores RA, Padrón-Lucio J, Germán-Garrido CO, Gorostieta-Luján J, Campos-Salcedo JG

Language: Spanish
References: 22
Page: 366-374
PDF size: 302.29 Kb.


ABSTRACT

Background: Bipolar enucleation of the prostate can be an effective alternative to the technique of Holmium laser enucleation in patients with large adenomas.
Objective: To evaluate the efficacy and safety of bipolar enucleation of the prostate for the treatment of obstructive prostatic hyperplasia.
Materials and Methods: A retrospective, observational, analytic, and descriptive study was conducted on patients indicated for relative and absolute endourologic treatment of prostatic hyperplasia. The preoperative and postoperative (six months) parameters of IPSS, quality of life (QoL), prostate volume, prostate-specific antigen (PSA) levels, pre-micturition and post-micturition bladder volumes, and maximum urinary flow rate (Qmax) were analyzed. Perioperative characteristics: surgery duration, enucleated prostate tissue; enucleated tissue per time unit (g/min), hospital stay, and catheterization duration. The statistical analysis was carried out using the Excel program and the SPSS statistical package.
Results: Thirty patients were included in the study. Acute urinary retention was the most common indication for surgery (56%), followed by refractoriness to medical treatment (40%). In means, IPSS was 22.72 ± 7.65, prostate volume 92.97 ± 68.61, prostate-specific antigen 6.4 ± 4.38 ng/mL, surgery duration 113.97 ± 52.1 min, enucleated prostate tissue 65 ± 56.54 g, enucleation/resection efficacy 0.59 ± 0.35 g/ min, hospital stay 4.31 days, and postoperative catheterization duration 3.4 days. At month six of follow-up, none of the patients presented with acute urinary retention, mean prostate-specific antigen was 1.61 ± 0.7, and mean IPSS was 4.8 ± 2.1. Only two patients presented with mild stress urinary incontinence.
Conclusions: Bipolar enucleation of the prostate is a safe and effective alternative technique in patients with obstructive prostatic hyperplasia.


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