Bipolar Transurethral Enucleation of the Prostate: Is it a size-independent endoscopic treatment option for symptomatic benign prostatic hyperplasia?

<h4>Background</h4>Bipolar Transurethral Enucleation of the Prostate (B-TUEP) is recommended as a first-choice treatment for benign prostatic obstruction in prostates >80 ml. Differently, B-TUEP is only considered as an alternative option after TURP for smaller prostates (30-80 ml). T...

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Autores principales: Carolina Bebi, Matteo Turetti, Elena Lievore, Francesco Ripa, Lorenzo Rocchini, Matteo Giulio Spinelli, Elisa De Lorenzis, Giancarlo Albo, Fabrizio Longo, Franco Gadda, Paolo Guido Dell'Orto, Andrea Salonia, Emanuele Montanari, Luca Boeri
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Publicado: Public Library of Science (PLoS) 2021
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spelling oai:doaj.org-article:cc06dae820a0419db55640336b8ad93f2021-12-02T20:10:52ZBipolar Transurethral Enucleation of the Prostate: Is it a size-independent endoscopic treatment option for symptomatic benign prostatic hyperplasia?1932-620310.1371/journal.pone.0253083https://doaj.org/article/cc06dae820a0419db55640336b8ad93f2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0253083https://doaj.org/toc/1932-6203<h4>Background</h4>Bipolar Transurethral Enucleation of the Prostate (B-TUEP) is recommended as a first-choice treatment for benign prostatic obstruction in prostates >80 ml. Differently, B-TUEP is only considered as an alternative option after TURP for smaller prostates (30-80 ml). The aim of our study is to assess the relation between prostate size and surgical outcomes after B-TUEP.<h4>Methods</h4>We performed a retrospective analysis of data collected from 172 patients submitted to B-TUEP. Patients were segregated according to tertiles of prostate volume (PV) (≤60 ml, 61-110 ml, >110 ml). For each group we evaluated enucleation efficacy (enucleated weight/enucleation time), complication rates, urinary and sexual function parameters. Functional and sexual parameters were compared between groups at baseline, 1 and 3 months follow up. Descriptive statistics and linear and logistic regression models tested the association between PV and postoperative complications/outcomes.<h4>Results</h4>Operative time and weight of enucleated adenomas increased along with prostate volumes (all p≤0.01). Enucleation efficacy was higher in men with PV >110 ml compared to other groups (p≤0.001). Length of hospital stay, catheterization time and rates of postoperative complications, such as transfusion and clot evacuation rates and bladder neck/urethral strictures, were comparable between groups. Urinary symptoms improved at 1-and 3-months in each group as compared to baseline evaluation (all p<0.01) but they did not differ according to PV. In each group maximum urinary flow and post-void residual volume significantly improved at 3 months compared to baseline (all p≤0.01), without differences according to PV. Sexual symptoms were similar between groups at each follow up assessment. At multivariable linear and logistic regression analysis, prostate volume was not associated with postoperative functional outcomes and complications. Conversely, patient's comorbid status and antiplatelet/anticoagulation use were independently associated with postoperative complications.<h4>Conclusion</h4>According to our findings, B-TUEP should be considered a "size independent procedure" as it can provide symptom relief in men with prostates of all sizes with the same efficacy and safety profile.Carolina BebiMatteo TurettiElena LievoreFrancesco RipaLorenzo RocchiniMatteo Giulio SpinelliElisa De LorenzisGiancarlo AlboFabrizio LongoFranco GaddaPaolo Guido Dell'OrtoAndrea SaloniaEmanuele MontanariLuca BoeriPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 6, p e0253083 (2021)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Carolina Bebi
Matteo Turetti
Elena Lievore
Francesco Ripa
Lorenzo Rocchini
Matteo Giulio Spinelli
Elisa De Lorenzis
Giancarlo Albo
Fabrizio Longo
Franco Gadda
Paolo Guido Dell'Orto
Andrea Salonia
Emanuele Montanari
Luca Boeri
Bipolar Transurethral Enucleation of the Prostate: Is it a size-independent endoscopic treatment option for symptomatic benign prostatic hyperplasia?
description <h4>Background</h4>Bipolar Transurethral Enucleation of the Prostate (B-TUEP) is recommended as a first-choice treatment for benign prostatic obstruction in prostates >80 ml. Differently, B-TUEP is only considered as an alternative option after TURP for smaller prostates (30-80 ml). The aim of our study is to assess the relation between prostate size and surgical outcomes after B-TUEP.<h4>Methods</h4>We performed a retrospective analysis of data collected from 172 patients submitted to B-TUEP. Patients were segregated according to tertiles of prostate volume (PV) (≤60 ml, 61-110 ml, >110 ml). For each group we evaluated enucleation efficacy (enucleated weight/enucleation time), complication rates, urinary and sexual function parameters. Functional and sexual parameters were compared between groups at baseline, 1 and 3 months follow up. Descriptive statistics and linear and logistic regression models tested the association between PV and postoperative complications/outcomes.<h4>Results</h4>Operative time and weight of enucleated adenomas increased along with prostate volumes (all p≤0.01). Enucleation efficacy was higher in men with PV >110 ml compared to other groups (p≤0.001). Length of hospital stay, catheterization time and rates of postoperative complications, such as transfusion and clot evacuation rates and bladder neck/urethral strictures, were comparable between groups. Urinary symptoms improved at 1-and 3-months in each group as compared to baseline evaluation (all p<0.01) but they did not differ according to PV. In each group maximum urinary flow and post-void residual volume significantly improved at 3 months compared to baseline (all p≤0.01), without differences according to PV. Sexual symptoms were similar between groups at each follow up assessment. At multivariable linear and logistic regression analysis, prostate volume was not associated with postoperative functional outcomes and complications. Conversely, patient's comorbid status and antiplatelet/anticoagulation use were independently associated with postoperative complications.<h4>Conclusion</h4>According to our findings, B-TUEP should be considered a "size independent procedure" as it can provide symptom relief in men with prostates of all sizes with the same efficacy and safety profile.
format article
author Carolina Bebi
Matteo Turetti
Elena Lievore
Francesco Ripa
Lorenzo Rocchini
Matteo Giulio Spinelli
Elisa De Lorenzis
Giancarlo Albo
Fabrizio Longo
Franco Gadda
Paolo Guido Dell'Orto
Andrea Salonia
Emanuele Montanari
Luca Boeri
author_facet Carolina Bebi
Matteo Turetti
Elena Lievore
Francesco Ripa
Lorenzo Rocchini
Matteo Giulio Spinelli
Elisa De Lorenzis
Giancarlo Albo
Fabrizio Longo
Franco Gadda
Paolo Guido Dell'Orto
Andrea Salonia
Emanuele Montanari
Luca Boeri
author_sort Carolina Bebi
title Bipolar Transurethral Enucleation of the Prostate: Is it a size-independent endoscopic treatment option for symptomatic benign prostatic hyperplasia?
title_short Bipolar Transurethral Enucleation of the Prostate: Is it a size-independent endoscopic treatment option for symptomatic benign prostatic hyperplasia?
title_full Bipolar Transurethral Enucleation of the Prostate: Is it a size-independent endoscopic treatment option for symptomatic benign prostatic hyperplasia?
title_fullStr Bipolar Transurethral Enucleation of the Prostate: Is it a size-independent endoscopic treatment option for symptomatic benign prostatic hyperplasia?
title_full_unstemmed Bipolar Transurethral Enucleation of the Prostate: Is it a size-independent endoscopic treatment option for symptomatic benign prostatic hyperplasia?
title_sort bipolar transurethral enucleation of the prostate: is it a size-independent endoscopic treatment option for symptomatic benign prostatic hyperplasia?
publisher Public Library of Science (PLoS)
publishDate 2021
url https://doaj.org/article/cc06dae820a0419db55640336b8ad93f
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