[Democratization of the anatomical endoscopic enucleation of the prostate with bipolar energy]

Bipolar enucleation of the prostate (BipolEP) has emerged as an effective, safe, and cost-efficient surgical option for managing benign prostatic hyperplasia (BPH), particularly in large glands. The objective of this study was to analyze recent evidence on BipolEP and comparing it with other endoscopic enucleation techniques using holmium and thulium lasers. It was carried out a review through a search of articles published in PubMed between 2020 and 2025, and 35 relevant studies were included. Evidence analyzed demonstrate that BipolEP achieves complete adenoma removal, improves Qmax and IPSS, and reduces postvoid residual volume, with complication rates comparable to those of laser-based technologies. Its superior hemostatic profile lowers equipment costs that enable complete enucleation and adenoma resection with the mushroom technique without the need for a morcelator, while at the same time it eases a shorter learning curve, because urologists are accustomed to the bipolar resectocope and they support its implementation in resource-limited settings. However, although available data confirm its efficacy and reproducibility, it remains the need for multicenter studies with long-term follow-up to consolidate its durability and standardization.