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

Tung-Shiun Hsu; Shu-Chuan Weng; Yu-Hsiang Lin; Chien-Lun Chen; Shu-Han Tsao; Han-Yu Tsai; Horng-Heng Juang; Phei-Lang Chang; Chen-Pang Hou

doi:10.1007/s11255-024-04007-7

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

Int Urol Nephrol. 2024 Apr 2. doi: 10.1007/s11255-024-04007-7. Online ahead of print.

Authors

Tung-Shiun Hsu^{1

2}, Shu-Chuan Weng^{3

4}, Yu-Hsiang Lin^{1

2}, Chien-Lun Chen¹, Shu-Han Tsao¹, Han-Yu Tsai¹, Horng-Heng Juang², Phei-Lang Chang¹, Chen-Pang Hou^{5

6

7}

Affiliations

¹ Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan, 333, Taiwan.
² School of Medicine, Chang Gung University, Taoyuan, 333, Taiwan.
³ Department of Health and Management, Yuanpei University of Medical Technology, Hsinchu, 330, Taiwan.
⁴ Bachelor Degree Program of Senior Health and Management, Yuanpei University of Medical Technology, Hsinchu, 330, Taiwan.
⁵ Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan, 333, Taiwan. glucose1979@gmail.com.
⁶ Department of Health and Management, Yuanpei University of Medical Technology, Hsinchu, 330, Taiwan. glucose1979@gmail.com.
⁷ School of Medicine, Chang Gung University, Taoyuan, 333, Taiwan. glucose1979@gmail.com.

PMID: 38564078
DOI: 10.1007/s11255-024-04007-7

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.