#1403

Anatomic Endoscopic Enucleation of the Prostate using Mini Bipolar Energy Modality

S. Bulaong¹, K. Tan¹, E. Madrona²

¹veterans meorial medical center, Urology, Quezon City, Philippines
²Veterans Memorial Medical Center, Urology, Quezon City, Philippines

Introduction:

Bipolar enucleation of the prostate is a surgical procedure used to treat benign prostatic hyperplasia (BPH) . It involves the removal of the adenoma of the prostate within the prostatic capsule. BipolEP is usually performed with bipolar energy, The end product is the same with either HoLEP therapy, but the learning curve and equipment costs of BipolEP are more favorable . BipolEP is an effective and safe procedure for patients with larger prostates, usually over 80 mL in size, or those in urinary retention . It is a complete removal of the adenoma, giving the longest-lasting results. hemostasis is the greatest advantage of BipolEP when compared TUR or laser enucleation.

Material and methods:

Mini-Bipolar enucleation of the prostate (BipolEP) is a minimally invasive surgical procedure (using f22 Resectosope) used to treat benign prostatic enlargement. we used a specialized f22 resectoscope into the urethra and uses bipolar energy on the scope to enucleate all adenoma tissue. Compared with conventional transurethral resection. It is an effective and safe procedure with a steep learning curve . The procedure involves making circular incisions on the bladder neck and mucosa at the level of verumontanum with early apical release. Then, enucleation is performed in the order of median and lateral lobes towards the bladder neck. Hemostasis should be done throughout the procedure to properly visualize the field. After enucleation and hemostasis, prostatic adenoma is evacuated using a morcellator. BipoLEP uses a bipolar endoscopic instrument with normal saline irrigation, which eliminates the risk of transurethral resection syndromes (TUR syndromes) . The procedure usually takes 45 minutes to two hours, depending on the size of the prostate . Unlike similar surgical procedures performed for prostates, BipolEP does not require abdominal incisions. The result is faster recovery, lower risk of infections and patients can recover at home .BipolEP is an effective minimally invasive option for treating moderate-to-severe lower urinary tract symptoms secondary to benign prostatic obstruction in patients with large prostates . The ideal patient for bipolar enucleation will have a larger prostate, usually over 80 mL in size, or be in urinary retention . In either situation, the enucleation procedures have shown to be most effective.

Results:

The total operative time was 41 minutes,58 grams of tissue were removed. The catheter was removed on the 2nd post-operative day. The patient stayed in the hospital for 2 days and there were no peri/post-operative complications.