廣華醫院 外科部 泌尿科
Postoperative outcomes and safety of bipolar transurethral enucleation and resection of the prostate
Kwun-Wai Chan, Chak-Lam Cho, Wing-Hong Chu, In-Chak Law
Divisions of Urology, Department of Surgery, Kwong Wah Hospital, Hong Kong
Purpose: Bipolar transurethral enucleation and resection of the prostate (TUERP) has been reported to be a method in the management of benign prostatic hyperplasia (BPH), especially for large prostate glands. Our objective was to report the early postoperative outcomes and safety of the bipolar TUERP technique.
Materials and Methods: A total of 30 consecutive patients had undergone bipolar TUERP by a single surgeon. All patients were evaluated preoperatively by physical examination, digital rectal examination, transrectal ultrasonography and blood tests, including haemoglobin, sodium level and prostate specific antigen measurement. Patients were assessed peri-operatively and postoperatively at 1, 3, 6 and 12 months.
Results: The mean enucleated prostatic adenoma specimen weight was 52.6g. The mean enucleation, resection and operative time were 13.6, 47.7 and 91.5 minutes respectively. The mean decrease in serum PSA after bipolar TUERP was 87.8% (from 6.36 to 0.86 ng/mL). Prostate volume was decreased by 68.6% at 4 weeks postoperatively. The mean haemoglobin drop was 1.18 g/dL. The rate of transient urinary incontinence at 3 month was 3.6%. None of the patients required blood transfusion or developed clot retention. One patient required re-catheterization and successfully weaned off catheter 1 week later. Patients who underwent bipolar TUERP had short catheterization time and hospital stay comparable to TURP patients.
Bipolar TUERP is the safe and efficient endourological equivalent of open prostatectomy with fewer complications and shorter convalescence. The technique of bipolar TUERP has a satisfactory early functional outcomes and low morbidity.