Bipolar Needlescopic Enucleation vs Bipolar Vapoenucleation of the Prostate: A Prospective, Single-Center Randomized...

Endoscopic enucleation of the prostate (EEP) is a safe and effective intervention option for management of variable-sized adenomas. The aim of this study was to point out the safety and efficacy of bipolar needlescopic enucleation of the prostate (BNEP) in comparison with bipolar vapoenucleation of the prostate (BVEP). This is a prospective randomized trial. In all, 214 patients with variable size adenoma were randomly assigned (1:1) to either the BNEP group (108 patients who underwent bipolar endoscopic enucleation of the prostate [BEEP] using a needle electrode) or the vapoenucleation (BVEP) group (106 patients who underwent BEEP using vaporization electrodes). Intra- and intergroup objective and subjective outcomes were compared at different time points for 1 year. In addition, all other procedure-related events and mishaps were registered and compared. The medians (interquartile ranges) for operative time (OT), resected tissue weight, postoperative irrigation time, and hemoglobin drop were 60 (50-88) vs 80 (60-98) minutes, 67 (56-86) vs 46 (40-61) grams, 10 (8-12) vs 12 (10-18) hours, and 1 (0.6-1.3) vs 1.2 (0.88-1.9) g/dL for BNEP and BVEP groups, respectively (p < 0.05). Both subjective and objective parameters were analogously improved in the two groups (p > 0.5). However, the postoperative irritative symptoms and urinary infections were lower in the BNEP group (p < 0.05). Our results revealed that although both BNEP and BVEP are effective and safe in the management of benign prostatic obstruction, BNEP is superior in terms of less OT, intraoperative blood loss, irrigation time, irritative symptoms, and urinary infections.