Long-Term Outcomes Following Bipolar Transurethral Plasma Enucleation of the Prostate: 10-Year Follow-Up

The aim of our study is to assess the long-term outcomes and safety of bipolar transurethral plasma enucleation of the prostate (B-TUEP) in patients with lower urinary tract symptoms (LUTS) in a single-center cohort study. Our focus is to evaluate the impact on outcomes after 10 years of follow-up (FUP) in terms of recurrence, LUTS, and patients' quality of life after B-TUEP in prostates between 30 and 80 cc. Between May 2010 and December 2011, all consecutive patients with benign prostatic hyperplasia undergoing B-TUEP were prospectively enrolled in our study. Data on patients' history, physical examination, prostate volumes, erectile function, prostate-specific antigen levels, International Prostate Symptoms Score (IPSS), and uroflowmetry were collected at 0, 1, 3, 6, 12, 24, 36, 60, and 120 months. Early and long-term complications were recorded. A total of 50 consecutive patients underwent B-TUEP in our facility, all performed by a single surgeon (R.G.). Twelve patients were excluded during the 10 years. No patients had persistent bladder outlet obstruction (BOO) requiring reoperation. In terms of results, the improvement in IPSS was sustained throughout 5 years, and the mean difference from baseline at 5 years was 17 points, with similar results at 10 years. Erectile function was also slightly improved after surgery and maintained for the next 5 years, with a slight age-related decrease at 10 years. Furthermore, the improvements in maximum urine flow rate (Qmax) were maintained at 5 years, with a mean improvement of 16 mL/s, while at 10 years, it settled on a mean improvement from baseline of 12 mL/s. In our 10 years' experience, B-TUEP is a safe and highly effective technique for relieving BOO, with excellent outcomes and no recurrence at 10 years of FUP. Further multicenter studies should confirm our results.