Bipolar Electrosurgical Enucleation of the Prostate: Technical progress and early clinical experience of a novel technique
Jessica Mandeville, MD, Robert A. Roth, MD, Arthur Mourtzinos, MD.
Lahey Clinic Medical Center, Burlington, MA, USA.
BACKGROUND: Bipolar transurethral resection of the prostate (TURP) and holmium laser enucleation of the prostate (HoLEP) have an urodynamically proven efficacy to relieve bladder outlet obstruction, which seems to be durable in time with low long-term complication rates. Both techniques have minimized bleeding risk and eliminated transurethral resection syndrome. We present our early clinical experience with bipolar enucleation of the prostate (BEP), a novel technique using the plasma-cise generator electrode as an alternative to transurethral resection of the prostate and HoLEP in patients with lower urinary tract symptoms secondary to bladder outlet obstruction from benign prostatic hypertrophy.
METHODS: We prospectively analyzed our first 20 consecutive patients who underwent BEP between December 2007 and October 2008 with a minimum of 6 month follow-up. All patients were evaluated at baseline and follow-up by medical history, International Prostate Symptom Score, inclusive of the question on quality of life, physical examination, and bladder postvoid residual.
RESULTS: Improvements in flow rate, International Prostate Symptom Score, quality-of-life score, and bladder outlet obstruction grade were comparable to results reported in the literature for both bipolar TURP and HoLEP. One patient had previously undergone a minimally invasive procedure for bladder outlet obstruction. One patient developed a fossa navicularis stricture that was managed conservatively.
CONCLUSIONS: Our initial data suggest that BEP using the plasma-cise generator electrode is safe and effective. It may represent a valid alternative to bipolar TURP and HoLEP. Long term studies will help to substantiate our short term results.