Bipolar resection versus enucleation of the prostate in management of benign prostatic hyperplasia patients with large-sized prostates: a prospective randomized controlled clinical trial
Abstract
Transurethral resection of the prostate (TURP) remains the standard surgical treatment for benign prostatic hyperplasia (BPH), but its efficacy decreases in large prostates. Bipolar enucleation of the prostate (BipolEP) has been introduced as a modification enabling complete adenoma removal and potentially superior outcomes. This study compared the efficacy and safety of bipolar TURP (B-TURP) and BipolEP in patients with large prostate volumes (≥ 80 mL). Seventy patients with prostate volume ≥ 80 mL and bladder outlet obstruction were prospectively randomized to undergo either B-TURP (n = 37) or BipolEP (n = 33). Both procedures were performed using standardized bipolar platforms. Postoperative management followed uniform bladder irrigation and catheterization protocols. Primary outcomes were functional parameters (IPSS, Qmax, PVR), while secondary outcomes included perioperative parameters and complications. ANCOVA analysis adjusting for baseline IPSS and Qmax, and Post-hoc power analysis were performed. Both groups showed significant postoperative improvement in IPSS, Qmax, and PVR (p < 0.001). Compared with B-TURP, BipolEP achieved a greater reduction in IPSS (p = 0.04) and higher postoperative Qmax (p = 0.004). Operative time, irrigation volume, catheterization duration, and residual tissue were all significantly lower in the BipolEP group (p < 0.05). Retrograde ejaculation occurred more frequently after BipolEP (81.8% vs. 48.6%, p = 0.004), whereas other complications…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 37 participants or records.
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