Monopolar Transurethral Enucleo-Resection of the Prostate (TUERP) versus HoLEP: A Canadian Novel Experience

To study the functional outcome of patients undergoing transurethral enucleation of the prostate (TUERP) versus patients undergoing Holmium laser enucleation of the prostate (HoLEP) in men with refractory benign prostatic hyperplasia (BPH).

We retrospectively analyzed our prospectively collected database of 2 groups of patients. 24 patients underwent TUERP (group 1), and 27 underwent HoLEP (group 2). Preoperative characteristics, intervention parameters, postoperative functional outcomes, uroflowmetry and complications were collected.

Mean prostate size in groups 1 and 2 were 87.2cc and 93.5cc, respectively. The mean duration of surgery was 110 min in group 1 and 136 min in group 2. In group 1, PSA dropped from 4.4 ng/ml to 1.2 ng/ml after 12 months. IPSS was 3.75 at 12 months with a preoperative value of 20.9. With respect to Qmax, it increased to 21.8 ml/s from a preoperative value of 6.4 ml/s. In group 2, the PSA dropped from 7.6 ng/ml to 1.3 ng/ml. IPSS dropped from 22.3 to 3.8, Qmax increased from 7.7 mL/s to 22.5 mL/s. Hemoglobin, complications, and all studied parameters were not statistically significant between both groups.

In this study, TUERP was safe and efficacious in BPH patients with large glands. Modifications can be implemented on the standard TURP technique to treat patients with prostate sizes more than 70 cc.

Journal of endourology. 2018 Mar 28 [Epub ahead of print]

Khaled Ajib, Jospeh Zgheib, Noura Salibi, Marc Zanaty, Mila Mansour, Abdullah Alenizi, Assaad El-Hakim

Centre Hospitalier de L'Universite de Montreal, 25443, department of surgery, Montreal, Quebec, Canada ; ., Saint George Hospital University Medical Center, 37608, Division of Urology , Beirut, Beirut, Lebanon ; ., American University of Beirut, Faculty of Health Sciences, Beirut, Lebanon ; ., Hopital du Sacre-Coeur de Montreal, 67120, Section of Urology, Montreal, Quebec, Canada ; ., Centre Hospitalier de L'Universite de Montreal, 25443, Montreal, Quebec, Canada ; ., Security Forces Hospital, Ria\yadh, Saudi Arabia ; ., Hopital du Sacre-Coeur de Montreal, 67120, Montreal, Quebec, Canada ; .