Comparative Analysis of Enucleation Techniques for Large Benign Prostatic Hyperplasia (>80 cm3) in Older Adult Patients: A Single-Center Cohort Study
Abstract
Purpose To evaluate and compare the safety, efficacy, and patient-centered outcomes of three enucleation techniques—bipolar transurethral enucleation of the prostate (B-TUEP), thulium laser enucleation (ThuLEP), and robotic-assisted simple prostatectomy (RASP)—in older adult patients (>60 years) with large-volume benign prostatic hyperplasia (BPH >80 cm3), a population at increased surgical risk and underrepresented in prior comparative studies. Patients and Methods This study retrospectively analyzed 127 patients aged 60 to 90 years who underwent B-TUEP (n=43), ThuLEP (n=58), or RASP (n=26) between 2014 and 2024. All procedures were performed by a single surgeon. Preoperative and 12-month postoperative outcomes—including IPSS, Qmax, post-void residual (PVR), and quality of life (QoL)—were assessed. Complication profiles, including urinary tract infection (UTI), prolonged analgesic requirement (PAR), and unexpected return visits (URV), were evaluated to reflect real-world risks in the older adults population. Results All three surgical techniques resulted in significant and sustained improvements in IPSS, Qmax, and PVR, with no significant intergroup differences at 12 months. ThuLEP demonstrated the lowest postoperative pain and analgesic use, RASP had the lowest UTI incidence, and B-TUEP was associated with the shortest operative time. Kaplan–Meier analysis showed comparable long-term medication-free survival across groups (p = 0.085). Quality of life scores improved in all…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 127 participants or records.
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