Can the Sandwich Method Be an Alternative Treatment Choice for BPH Patients With Large Prostates?

Tsu-Chen Lin; Chen-Pang Hou; Yu-Chao Hsu; Yu Chen; Kai-Jie Yu; I-Hung Shao; Ming-Li Hsieh

doi:10.1016/j.urology.2023.02.043

Can the Sandwich Method Be an Alternative Treatment Choice for BPH Patients With Large Prostates?

Urology. 2023 Jun:176:137-142. doi: 10.1016/j.urology.2023.02.043. Epub 2023 Mar 23.

Authors

Tsu-Chen Lin¹, Chen-Pang Hou², Yu-Chao Hsu³, Yu Chen⁴, Kai-Jie Yu³, I-Hung Shao³, Ming-Li Hsieh⁵

Affiliations

¹ Division of Urology, Department of Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
² Division of Urology, Department of Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Healthcare Management, Yuanpei University of Medical Technology, Hsinchu, Taiwan.
³ Division of Urology, Department of Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
⁴ Division of Urology, Department of Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan; School of Medicine, National Tsing Hua University, Hsinchu, Taiwan.
⁵ Division of Urology, Department of Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan. Electronic address: h0810@cgmh.org.tw.

PMID: 36963671
DOI: 10.1016/j.urology.2023.02.043

Abstract

Objective: To compare the efficacy and safety of the sandwich method with GreenLight photoselective vaporization (GLPVP) and bipolar transurethral resection (B-TURP) with those of the enucleation method in patients with BPH and a prostate volume ≥ 80 g.

Methods: Patients with BPH who underwent either the sandwich method with GLPVP and B-TURP or the enucleation method between 2014 and 2021 were included in the analysis. The primary outcome was the comparison of uroflowmetry results between the 2 groups. Safety analysis of the complication rates was also compared.

Results: The cohort included 55 patients in the sandwich group and 41 patients in the enucleation group. In the efficacy analysis, both groups showed comparable uroflowmetry results, except for a higher postoperative average flow rate in the enucleation group. Regarding perioperative parameters, the sandwich method required a longer operating time, and the enucleation group had a higher incidence of manual Foley irrigation. Both groups demonstrated similar postoperative complications.

Conclusion: The sandwich method exhibited comparable efficacy and safety to the enucleation method in patients with BPH with a prostate volume ≥ 80 g. Thus, for surgeons who are familiar with GLPVP and B-TURP, the sandwich method may be an alternative surgical approach for BPH patients with large prostates.

MeSH terms

Humans
Laser Therapy* / methods
Male
Prostate / surgery
Prostatic Hyperplasia* / complications
Prostatic Hyperplasia* / surgery
Transurethral Resection of Prostate* / methods
Treatment Outcome