Evaluation of the clinical efficacy of transurethral bipolar surgery and laser technologies in the treatment of patients with benign prostatic hyperplasia
- Authors: Suleimanov S.I.1,2, Aguzarov A.M.2, Ashurov Z.I.2, Babkin A.S.2, Bagaturiya K.K.2, Musokhranov V.V.2, Tyagun A.A.2, Fedorov D.A.2
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Affiliations:
- People’s Friendship University of Russia
- City Clinical Hospital No. 13
- Issue: Vol 14, No 2 (2024)
- Pages: 139-146
- Section: Original articles
- URL: https://journals.eco-vector.com/uroved/article/view/624420
- DOI: https://doi.org/10.17816/uroved624420
- ID: 624420
Cite item
Abstract
BACKGROUND: Benign prostatic hyperplasia (BPH) is common middle-aged and elderly men. In modern urology, transurethral resection and its modifications are used in surgical treatment of BPH. In the last decades, an active tendency of laser technologies development in urology was noted. The search for the most appropriate techniques of transurethral removal of prostate adenoma by comparing the results of treatment of patients with the use of different technologies remains relevant.
AIM: This study aimed to evaluate the clinical effectiveness of transurethral bipolar surgery and laser technologies in the treatment of BPH.
MATERIALS AND METHODS: Transurethral enucleation of the prostate using various technologies was performed in 273 patients with BPH between 2021 and 2023: 94 patients underwent bipolar transurethral enucleation of the prostate, 87 underwent thulium enucleation of the prostate (ThuLEP), and 92 underwent holmium enucleation of the prostate (HoLEP).
RESULTS: Clinical evaluation showed the absence of intraoperative complications. For ThuLEP, a trend toward shorter operative times compared to other techniques was observed. In the early postoperative period, significant bleeding was noted in six cases of using bipolar technology, three cases of using a thulium laser, and five cases of using a holmium laser. An examination of patients 6 months postsurgery showed pronounced positive dynamics in all three groups. No significant differences were found in clinical parameters 6 months postsurgery in patients of different groups.
CONCLUSIONS: Bipolar enucleation of the prostate, ThuLEP, and HoLEP are comparable in effectiveness and the number of complications in the surgical treatment of BPH. Study results indicated that it is advisable to actively use these methods in wide clinical practice.
About the authors
Suleiman I. Suleimanov
People’s Friendship University of Russia; City Clinical Hospital No. 13
Author for correspondence.
Email: s.i.suleymanov@mail.ru
ORCID iD: 0000-0002-0461-9885
SPIN-code: 7168-8819
Scopus Author ID: 57080003900
MD, Dr. Sci. (Medicine)
Russian Federation, Moscow; MoscowAlan M. Aguzarov
City Clinical Hospital No. 13
Email: aguzarofff@ya.ru
MD
Russian Federation, MoscowZaur I. Ashurov
City Clinical Hospital No. 13
Email: zaur_ashurov@mail.ru
MD
Russian Federation, MoscowAleksandr S. Babkin
City Clinical Hospital No. 13
Email: alexbabkin3004@mail.ru
ORCID iD: 0000-0003-1570-1793
MD
Russian Federation, MoscowKonstantin K. Bagaturiya
City Clinical Hospital No. 13
Email: buba-190@rambler.ru
MD
Russian Federation, MoscowVladislav V. Musokhranov
City Clinical Hospital No. 13
Email: vlad412@mail.ru
ORCID iD: 0000-0003-1336-931X
MD, Cand. Sci. (Medicine)
Russian Federation, MoscowAlexander A. Tyagun
City Clinical Hospital No. 13
Email: tyagun1976@gmail.com
MD
Russian Federation, MoscowDmitry A. Fedorov
City Clinical Hospital No. 13
Email: fedorov3867@icloud.com
ORCID iD: 0000-0002-6232-2078
MD
Russian Federation, MoscowReferences
- Berry SJ, Coffey DS, Walsh PC, Ewing LL. The development of human benign prostatic hyperplasia with age. J Urol. 1984;132(3): 474–479. doi: 10.1016/s0022-5347(17)49698-4
- Park HJ, Won JEJ, Sorsaburu S, et al. Urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) and LUTS/BPH with erectile dysfunction in Asian men: A systematic review focusing on Tadalafil. World J Mens Health. 2013;31(3):193–207. doi: 10.5534/wjmh.2013.31.3.193
- Zolotukhin OV, Esin AV, Madykin YuYu. Pathogenetic justification of the use of 5-alpha reductase inhibitors in the treatment of benign prostatic hyperplasia. Experimental and Clinical Urology. 2022;(3) 94–101. EDN: LCBERR doi: 10.29188/2222-8543-2022-15-3-94-101
- Bushman W. Etiology, epidemiology, and natural history of benign prostatic hyperplasia. Urol Clin North Am. 2009;36(4):403–415. doi: 10.1016/j.ucl.2009.07.003
- Sevryukov FA, Sorokin DA, Karpukhin IV, et al. Transurethral enucleation of prostate (TUEB) — new option in bipolar endoscopic surgery of BPH. Experimental and Clinical Urology. 2012;(2):34–36. EDN: PDARMH
- Trushkin RN, Sysoev AM. Transurethral enucleation of prostate gland by bipolar loop — the first experience. Surgical practice. 2014;(4):41–43. EDN: TMQKIT (In Russ.)
- Kadyrov ZA, Suleymanov SI, Eremeishvili GM, et al. Extraperitoneal laparoscopic prostatectomy for benign prostatic hyperplasia in larger sizes. Andrology and genital surgery. 2012;13(3):19–24. EDN: PGOUEZ
- Enikeev DV, Glybochko PV, Alyaev YuG, et al. Laser enucleation of the prostate (HOLEP and THULEP): a comparative effectiveness analysis in treating recurrent prostatic hyperplasia. Urologiia. 2017. № 4. С. 50–54. EDN: ZFVHRJ doi: 10.18565/urol.2017.4.50-54
- Enikeev DV, Glybochko PV, Alyaev YuG, et al. Current laser technologies for the surgical treatment of prostatic hyperplasia. Urologiia. 2017;(1):108–113. EDN: YJAMHR doi: 10.18565/urol.2017.1.108-113
- Shoma AM, Ghobrial FK, El-Tabey N, et al. A randomized trial of holmium laser vs thulium laser vs bipolar enucleation of large prostate glands. BJU Int. 2023;132(6):686–695. doi: 10.1111/bju.16174
- Chen J, Dong W, Gao X, et al. A systematic review and meta-analysis of efficacy and safety comparing holmium laser enucleation of the prostate with transurethral resection of the prostate for patients with prostate volume less than 100 mL or 100 g. Transl Androl Urol. 2022;11(4):407–420. doi: 10.21037/tau-21-1005
- Gilling PJ, Cass CB, Cresswell MD, Fraundorfer MR. Holmium laser resection of the prostate: preliminary results of a new method for the treatment of benign prostatic hyperplasia. Urology. 1996;47(1):48–51. doi: 10.1016/s0090-4295(99)80381-1
- Herrmann TR, Bach T, Imkamp F, et al. Thulium laser enucleation of the prostate (ThuLEP): transurethral anatomical prostatectomy with laser support. Introduction of a novel technique for the treatment of benign prostatic obstruction. World J Urol. 2010;28(1):45–51. doi: 10.1007/s00345-009-0503-0
- Enikeev DV, Glybochko PV, Alyaev YuG, et al. Comparative analysis of the effectiveness of various techniques of endoscopic prostate enucleation in a single center. Pirogov Russian Journal of Surgery. 2017;(11):4–14. EDN: ZTTLZP doi: 10.17116/hirurgia2017114-14