[FIRST CASES OF ANTEROPOSTERIOR DISSECTION TUEB (TRANSURETHRAL ENUCLEATION WITH BIPOLAR)]

We examined the efficacy of anteroposterior dissection transurethral enucleation with bipolar (TUEB) for benign prostate hyperplasia (BPH).

We performed anteroposterior dissection TUEB on 21 patients with BPH between October 2012 and June 2013. In anteroposterior dissection TUEB, the lateral lobes are anteroposteriorly dissected from the 12 o'clock position to the 6 o'clock position after enucleation of the middle lobe. Mean age was 73 years, mean estimated prostate volume was 62.8 ml, mean estimated transition zone volume was 44.5 ml, mean International Prostate Symptom Score (IPSS) score was 15.5, mean quality of life (QOL) score was 4.1, peak flow rate (Qmax) was 8.6 ml/s, and mean residual urine volume was 42.4 ml.

The mean operation time was 69 min, the mean weight of removed prostate tissue was 27.3 g, and the mean decrease in hemoglobin level was 1.8 g/dl. Three months after surgery, mean IPSS score was 5.9, mean QOL score was 1.9, mean Qmax was 28 ml/s, and mean residual urine volume was 1.0 ml, values which were significantly improved over pre-surgery data. No complications such as perforation or bladder injury occurred during surgery, but 1 case (4.7%) of stress urinary incontinence and 1 case (4.7%) of urethral stricture were reported after surgery. Of note, urethral stricture was determined using a flexible cytoscope at 1 week, 1 month, and 3 months post-surgery.

Anteroposterior dissection TUEB can be conducted safely and may be useful in reducing frequency of urethral stricture post-surgery.