To evaluate surgical outcomes of patients who underwent complete or incomplete enucleation technique during a short-term postoperative period METHODS: Patients having intractable LUTS/BPH and prostates > 30 grams with obstructed pattern in the urodynamic examinations were included. They underwent TUR-P, 120 W greenlight laser HPS-PVEP, or HoLEP. Patients with the size of remnant prostates minus surgical defects < 25 grams were grouped into the completely enucleated group (group C) and other were group into the partially enucleated group (group P).
Mean PSA value was 3.5 ± 4.5 ng/mL and mean prostate volume was 58.4 ± 31.0 mL. Complete enucleation rates in TUR-P, HPS-PVEP, and HoLEP groups were 39% (37 out of 95), 54.6% (83 out of 152), and 54.4% (31 out of 57), respectively. Complete enucleation rate of the TUR-P was significantly lower than those of the other two groups. Compared to group C, group P had lower maximal flow rate, higher bladder outlet obstruction index, and higher overactive bladder symptom scores. Multivariate logistic regression analyses showed that smaller prostate, presence of intravesical prostatic protrusion, HoLEP operation, and surgeons' experience were significant predictors for achieving complete enucleation of prostate. Voiding subscores of group C were significantly higher than those of group P at postoperative 12 months.
The performance of HoLEP was superior to other surgical techniques. However, HPS-PVEP with vapoenucleation showed the comparable enucleation rate with that of HoLEP. Complete enucleation was effective in maintaining outcomes of prostate resection, especially voiding subscores.
Urology. 2017 Jul 19 [Epub ahead of print]
Sung Yong Cho, Juhyun Park, Sangjun You, Min Chul Cho, Hyeon Jeong, Hwancheol Son
Department of Urology, SMG-SNU Boramae Medical center, Seoul, Korea., Department of Urology, SMG-SNU Boramae Medical center, Seoul, Korea. Electronic address: .