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. 2024 Aug;56(8):2513-2519.
doi: 10.1007/s11255-024-04007-7. Epub 2024 Apr 2.

Surgical outcomes of endoscopic enucleation of the prostate in community aging males with or without preoperative urinary retention

Tung-Shiun Hsu  1   2 , Shu-Chuan Weng  3   4 , Yu-Hsiang Lin  1   2 , Chien-Lun Chen  1 , Shu-Han Tsao  1 , Han-Yu Tsai  1 , Horng-Heng Juang  2 , Phei-Lang Chang  1 , Chen-Pang Hou  5   6   7
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Surgical outcomes of endoscopic enucleation of the prostate in community aging males with or without preoperative urinary retention

Tung-Shiun Hsu et al. Int Urol Nephrol. 2024 Aug.

Abstract

Objectives: This study aims to investigate the surgical outcomes of endoscopic enucleation of the prostate in older males with or without preoperative urinary retention (UR).

Material and methods: We conducted a study on selected patients with symptomatic benign prostatic hyperplasia (BPH) who underwent either thulium:YAG laser (vela XL) prostate enucleation (ThuLEP) or bipolar plasma enucleation of the prostate (B-TUEP) at the geriatric urology department of our institution. The studied patients were categorized into two groups, namely the UR group and the non-UR group, on the basis of whether they experienced UR in the 1 month preceding their surgery. Their clinical outcomes following prostate endoscopic surgery were evaluated and analyzed.

Results: Our results revealed comparable outcomes for operation time, length of hospital stay, percentage of tissue removed, re-catheterization rate, and urinary tract infection rate within the 1 month between the B-TUEP and ThuLEP surgery groups, regardless of UR history. However, the non-UR B-TUEP group experienced more blood loss relative to the non-UR ThuLEP group (P = .004). Notably, patients with UR exhibited significantly greater changes in IPSS total, IPSS voiding, and prostate-specific antigen values relative to those without UR.

Conclusions: Both ThuLEP and B-TUEP were effective in treating BPH-related bladder outlet obstruction. Our study identified more pronounced changes in IPSS total, IPSS voiding, and prostate-specific antigens within the UR group. Moreover, the rate of postoperative UR in this group was not higher than that observed in the non-UR group. Our study also revealed that the presumed benefits of laser surgery in reducing blood loss were less pronounced for patients with UR.

Keywords: Benign prostate hyperplasia; Enucleation; Prostate; TURP; Thulium laser; Urinary retention.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
A Alterations in IPSS_t following the surgical procedure. The analysis found an interaction effect between the UR status and the values of IPSS_t at different time points, indicating that the changes in IPSS_t were significantly greater in the UR group than in the non-UR group. B the alterations in IPSS_v following the surgical procedure. The analysis found an interaction effect between the UR status and the values of IPSS_v at different time points, indicating that the changes in IPSS_v were significantly greater in the UR group than in the non-UR group. C The alterations in IPSS_s following the surgical procedure. D Significant improvements were observed in Qmax following the surgical procedure. E Significant improvements were observed in QoL VV following the surgical procedure. F Significant improvements were observed in QoL scores following the surgical procedure. G The changes in PSA level following the surgical procedure. The analysis found an interaction effect between the UR status and the values of PSA at different time points, indicating that the changes in PSA were significantly greater in the UR group than in the non-UR group
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