En Bloc Bipolar Prostate Enucleation Using the Mushroom Technique with Early Apical Release: Short-Term Outcomes

Area of Science:

• Urology
• Surgical Innovation
• Benign Prostatic Hyperplasia Treatment

Background:

• Transurethral resection of the prostate (TURP) is the standard surgical treatment for benign prostatic hyperplasia (BPH).
• Anatomical endoscopic enucleation of the prostate (AEEP) presents a safe, durable, and size-independent alternative to TURP.
• This study focuses on a novel en bloc bipolar prostate enucleation technique.

Purpose of the Study:

• To introduce and evaluate a specific technical innovation in enucleation: en bloc bipolar prostate enucleation.
• To assess the safety, efficacy, and outcomes of this technique combined with the mushroom technique and early apical release.
• To analyze perioperative results, postoperative outcomes, and complication profiles in patients with BPH.

Main Methods:

• A retrospective evaluation of 252 patients with prostate volumes > 30 mL and lower urinary tract symptoms.
• Patients underwent en bloc bipolar prostate enucleation using the mushroom technique with early apical release.
• Data collected included perioperative metrics, postoperative symptom scores, flow rates, and complication rates.

Main Results:

• The median patient age was 70 years, with a median prostate volume of 60 mL.
• Median operative time was 40 minutes, and median enucleated tissue weight was 34 g.
• Significant improvements in International Prostate Symptom Score, Quality of Life score, flow rates, and postvoid residual urine were observed (p < 0.001), with a decrease in transient stress urinary incontinence from 19.44% to 2.38% at 12 months.

Conclusions:

• En bloc bipolar prostate enucleation utilizing the mushroom technique is a safe and effective treatment for BPH.
• The technique leads to substantial improvements in urinary symptoms and flow rates.
• The complication profile is manageable, though further multicenter studies are recommended.