Urol. praxi. 2023;24(3):134-139 | DOI: 10.36290/uro.2023.060

Current perspective on transurethral enucleation procedures on prostate in benign prostatic hyperplasia

MUDr. Vladimír Valter, MUDr. Miroslav Krhovský

Urologické oddělení Nemocnice Kyjov

As one of the most common urological diagnosis of aging men, benign prostatic hyperplasia (BPH) affects almost 80% of males over 70. Despite dramatic progress in technological and surgical treatment options, it is still considered as feared diagnosis among patients. Majority of aging men choose conservative, pharmacological treatment which in many cases is unable to permanently solve the lower urinary tract symptoms (LUTS) and in many cases ends up with permanent catheterization of those unfortunate ones who missed a surgery while having a suitable performance status. For the past 70 years transurethral resection of the prostate (TURP) has been considered a gold standard in LUTS/BPH treatment. Although original monopolar technology is now replaced which much safer bipolar technology, TURP cannot be successfully used for prostate hyperplasias of excessive volumes. For these cases, open prostatectomy still remains a standardized option. Currently, modern literature points out that Holmium laser enucleation (HoLEP) has replaced TURP and open prostatectomy and is considered the new gold standard in BPH treatment. However, other technologies and techniques evolved, allowing transurethral bipolar enucleation of the prostate (TUBEP) without using laser technology and delivering similar results as HoLEP. We present an overview of existing transurethral enucleation methods for the treatment of BPH which are based on our knowledge performed in the Czech Republic, this article discusses the surgical principles and specifics of individual technologies as well as performance safety, side effects and long-term results.

Keywords: prostate hyperplasia, TUEP, TUBEP, HoLEP, ThuLEP, BPH, LUTS.

Accepted: September 25, 2023; Published: October 2, 2023  Show citation