Laparoscopic simple prostatectomy vs bipolar plasma enucleation of the prostate in large benign prostatic hyperplasia: a
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ORIGINAL ARTICLE
Laparoscopic simple prostatectomy vs bipolar plasma enucleation of the prostate in large benign prostatic hyperplasia: a two‑center 3‑year comparison Riccardo Lombardo1 · Anton Zarraonandia Andraca2 · Cristina Plaza Alonso2 · Juan Andres González‑Dacal2 · Higinio Rodríguez Núñez2 · Aaron Barreiro Mallo2 · Barbara Cristina Gentile1 · Giorgia Tema1 · Luca Albanesi1 · Luca Mavilla1 · Valeria Baldassarri3,4 · Cosimo De Nunzio3 · Andrea Tubaro3 · Manuel Ruibal Moldes2 · Roberto Giulianelli1 Received: 22 May 2020 / Accepted: 24 October 2020 © The Author(s) 2020
Abstract Purpose To compare surgery outcomes and safety of button bipolar enucleation of the prostate vs laparoscopic simple prostatectomy in patients with large prostates (> 80 g) in a two-center cohort study. Methods All patients with lower urinary tract symptoms due to benign prostatic enlargement (Prostate volume > 80 cc) undergoing button bipolar enucleation of the prostate (BTUEP) or laparoscopic simple prostatectomy (LSP) in two centers were enrolled. Data on clinical history, physical examination, urinary symptoms, uroflowmetry and prostate volume were collected at 0, 1, 3 6, 12, 24 and 36 months. Early and long-term complications were recorded. Results Overall, 296 patients were enrolled. Out of them, 167/296 (56%) performed a LSP and 129/296 (44%) performed a BTUEP. In terms of efficacy both procedures showed durable results at three years with a reintervention rate of 8% in the LSP group and of 5% in the BTUEP group. In terms of safety, BTUEP and LSP presented similar safety profiles with a 9% of transfusion rate and no major complications. Conclusion LSP and BTUEP are safe and effective in treating large-volume adenomas with durable results at three years when performed in experienced centers. Keywords BPH · Laparoscopic simple prostatectomy · BTUEP · LUTS · Prostatic disease
Introduction Transurethral resection of the prostate (TURP) is considered the standard procedure for men with prostates between 30 and 80 mL [1, 2]. In patients with larger prostates (> 80 cc), open prostatectomy (OP), holmium laser enucleation (HoLep) and bipolar enucleation (BTUEP) of the prostate represent the gold standard procedures for the management of patients with benign prostatic obstruction (BPO). The management of large adenomas is always challenging and
Riccardo Lombardo and Anton Zarraonandia Andraca contributed equally to the manuscript. * Valeria Baldassarri [email protected] Extended author information available on the last page of the article
nowadays, the chosen technique often lies on availability and surgeon preference. According to the latest EAU guidelines, the available techniques (OP; HoLep and bipolar enucleation) in the management of large adenomas (> 80 cc) may be considered equal in terms of short- and long-term functional outcomes [2]. The main limitation of OP is the high morbidity of the procedure, specially due to the high blood transfusion rate (7–14%) [3, 4]. HoLep is mainly limited by the steep learning curve
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