Results from a global multicenter registry of 6193 patients to refine endoscopic anatomical enucleation of the prostate (REAP) by evaluating trends and outcomes and nuances of prostate enucleation in a real-world setting.

To collect a multicentric, global database to assess current preferences and outcomes for endoscopic enucleation of the prostate (EEP).

Endourologists experienced in EEP from across the globe were invited to participate in the creation of this retrospective registry. Surgical procedures were performed between January 2020 and August 2022.

lower urinary tract symptoms not responding to or worsening despite medical therapy and absolute indication for surgery.

prostate cancer, concomitant lower urinary tract surgery, previous prostate/urethral surgery, pelvic radiotherapy.

Ten centers from 7 countries, involving 13 surgeons enrolled 6193 patients. Median age was 68 [62-74] years. 2326 (37.8%) patients had large prostates (> 80 cc). The most popular energy modality was the Holmium laser. The most common technique used for enucleation was the 2-lobe (48.8%). 86.2% of the procedures were performed under spinal anesthesia. Median operation time was 67 [50-95] minutes. Median postoperative catheter time was 2 [1, 3] days. Urinary tract infections were the most reported complications (4.7%) followed by acute urinary retention (4.1%). Post-operative bleeding needing additional intervention was reported in 0.9% of cases. 3 and 12-month follow-up visits showed improvement in symptoms and micturition parameters. Only 8 patients (1.4%) required redo surgery for residual adenoma. Stress urinary incontinence was reported in 53.9% of patients and after 3 months was found to persist in 16.2% of the cohort.

Our database contributes real-world data to support EEP as a truly well-established global, safe minimally invasive intervention and provides insights for further research.

World journal of urology. 2023 Oct 02 [Epub ahead of print]

Vineet Gauhar, Fernando Gómez Sancha, Dmitry Enikeev, Mario Sofer, Khi Yung Fong, Moisés Rodríguez Socarrás, Dean Elterman, Mallikarjuna Chiruvella, Mohammed Taif Bendigeri, Azimdjon N Tursunkulov, Abhay Mahajan, Tanuj Paul Bhatia, Sorokin Nikolai Ivanovich, Nariman Gadzhiev, Lie Kwok Ying, Biligere Sarvajit, Marco Dellabella, Vladislav Petov, Bhaskar Kumar Somani, Daniele Castellani, Thomas R W Herrmann

Department of Urology, Ng Teng Fong General Hospital, Singapore, Singapore., Department of Urology and Robotic Surgery, ICUA-Clínica CEMTRO, Madrid, Spain., Department of Urology, Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russian Federation., Department of Urology, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel., Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore., Division of Urology, Department of Surgery, University Health Network, University of Toronto, Toronto, Canada., Department of Urology, Asian Institute of Nephrology and Urology, Hyderabad, TG, India., Urology Division, AkfaMedline Hospital, Tashkent, Uzbekistan., Department of Urology, Sai Urology Hospital and MGM Medical College, Aurangabad, India., Department of Urology, Sarvodaya Hospital and Research Centre, Faridabad, Haryana, India., Department of Urology and Andrology, Lomonosov Moscow State University, Moscow, Russian Federation., Department of Urology, Saint-Petersburg State University Hospital, Saint-Petersburg, Russian Federation., Urology Unit, IRCCS INRCA, Ancona, Italy., Department of Urology, University Hospitals Southampton NHS Trust, Southampton, UK., Urology Unit, IRCCS INRCA, Ancona, Italy. ., Department of Urology, Kantonspital Frauenfeld, Spital Thurgau AG, Frauenfeld, Switzerland.