Endoscopic enucleation of the prostate (EEP) is a safe method of treating benign prostate hyperplasia (BPH), regardless of prostate volume and type of applied energy. To date, however, there has been no study that examines complication rates with respect to the type of applied energy. This study aims to address this problem by providing a retrospective analysis of over 1400 patients who have undergone prostate enucleation.
We performed a retrospective analysis of all patients undergoing EEP between 2013 and 2018 at a single tertiary institution. This analysis included patients who had undergone one of three forms of EEP: holmium laser (HoLEP), thulium fiber laser (ThuFLEP), or monopolar enucleation of the prostate (MEP). We compared intraoperative and early postoperative complications, as well as complications at 3 and 6 months follow up.
A total of 1413 patients were included in this study, 36% patients underwent HoLEP, 57.5% had ThuFLEP, and 6.5% - MEP. The most frequent complication in the early postoperative period was a mild fever (2.76% of the cases). The morcellation was delayed to a separate stage due to intensive hemorrhaging in 1.4% of the cases. Bladder tamponade was found in 1.1% of the cases. We found no correlation between complication rate and either prostate volume or energy source. Stress urinary incontinence was found in 3.9% of patients at 3 months and in only 1.4% of patients at 6 months after the operation. Urethral stricture at 6 months after the surgery was found in 1.4% of patients while bladder neck sclerosis was found in only 0.9% of these cases. No significant difference was observed between these complication frequencies and any preoperative factors or energy source.
All EEP types are safe with equal rates of complications intraoperatively, postoperatively and at 6 months follow up.
Journal of endourology. 2019 Dec 06 [Epub ahead of print]
Andrey Morozov, Mark Sergeevich Taratkin, Vasiliy Kozlov, Alexander Tarasov, Evgeniy Bezrukov, Mikhail Enikeev, Andrew Shea Afyouni, Zhamshid Okhunov, Petr Vitalievich Glybochko, Dmitry Enikeev
Sechenov University, Institute for Urology and Reproductive Health, Moscow, Russian Federation; ., Sechenov University, Institute for Urology and Reproductive Health, Moscow, Russian Federation; ., Sechenov University, Department of Public Health and Healthcare, Moscow, Russian Federation; ., Sechenov University, Institute of Linguistics and Intercultural Communication, Moscow, Russian Federation; ., Sechenov University, Institute for Urology and Reproductive Health, Moscow, Russian Federation; ., Sechenov University, Institute for Urology and Reproductive Health, Moscow, Russian Federation; ., University of California Irvine, 8788, Department of Urology, Irvine, California, United States; ., University of California, Irvine, Urology, Orange, California, United States., Sechenov University, Institute for Urology and Reproductive Health, Moscow, Russian Federation; ., Sechenov University, Institute for Urology and Reproductive Health, Moscow, Russian Federation; .