Can the Sandwich Method Be an Alternative Treatment Choice for BPH Patients With Large Prostates?

Area of Science:

• Urology
• Surgical Techniques
• Benign Prostatic Hyperplasia (BPH) Management

Background:

• Benign prostatic hyperplasia (BPH) affects a significant number of aging men.
• Surgical intervention is often required for symptomatic BPH.
• Large prostate volumes (≥ 80 g) present unique surgical challenges.

Purpose of the Study:

• To compare the efficacy and safety of the sandwich method (GreenLight photoselective vaporization [GLPVP] + bipolar transurethral resection [B-TURP]) with the enucleation method for BPH patients with large prostates (≥ 80 g).

Main Methods:

• Retrospective analysis of 96 BPH patients (55 sandwich group, 41 enucleation group) between 2014-2021.
• Primary outcome: comparison of uroflowmetry results.
• Secondary outcome: comparison of complication rates and perioperative parameters.

Main Results:

• Comparable uroflowmetry results between groups, with a higher postoperative flow rate in the enucleation group.
• Sandwich method had longer operating time; enucleation group had more Foley irrigations.
• Similar postoperative complication rates observed in both surgical approaches.

Conclusions:

• The sandwich method demonstrates comparable efficacy and safety to enucleation for BPH with prostate volume ≥ 80 g.
• This technique offers a viable alternative surgical option for surgeons proficient in GLPVP and B-TURP for managing large prostates.