Advertisement

Treatment of BPH: What Is the Gold Standard?

  • Chunxiao Liu
  • Abai Xu
  • Peng Xu
Chapter

Abstract

Transurethral resection of prostate (TURP) is considered as the gold standard surgical treatment of benign prostate hyperplasia (BPH). This recommendation has been challenged over the years due to high postoperative complication rates and symptoms recurrence. Modification and innovation of surgical techniques in BPH treatment is deemed necessary. In this article, we introduce the techniques of transurethral enucleation and resection of prostate, which will be the new standard of BPH management.

Keywords

BPH TURP Enucleation Endoscopic Morcellation 

Abbreviations

BPH

Benign prostatic hyperplasia

CHD

Coronary heart disease

COPD

Chronic obstructive pulmonary disease

DM

Diabetic mellitus

HoLEP

Holmium laser nucleation of the prostate

LUTS

Lower urinary tract symptoms:

PK

Plasma kinetics

QoL

Quality of life

TUERP

Transurethral enucleation and resection of the prostate

TUIP

Transurethral incision of the prostate

TURP

Transurethral resection of the prostate

References

  1. Capogrosso P, Ventimiglia E, Ferrari M, Serino A, Boeri L, Capitanio U, Briganti A, Damiano R, Montorsi F, Salonia A. Long-term sexual outcomes after holmium laser enucleation of the prostate: which patients could benefit the most? Int J Impot Res. 2016;28(5):189–93.PubMedCrossRefGoogle Scholar
  2. Chen YB, Chen Q, Wang Z, et al. A prospective, randomized clinical trial comparing plasmakinetic resection of the prostate with holmium laser enucleation of the prostate based on a 2-year followup. J Urol. 2013;189(1):217–22.PubMedCrossRefGoogle Scholar
  3. Elkoushy MA, Elshal AM, Elhilali MM. Postoperative lower urinary tract storage symptoms: does prostate enucleation differ from prostate vaporization for treatment of symptomatic benign prostatic hyperplasia? J Endourol. 2015;29(10):1159–65.PubMedCrossRefGoogle Scholar
  4. Elzayat EA, Elhilali MM. Holmium laser enucleation of the prostate (HoLEP): long-term results, reoperation rate, and possible impact of the learning curve. Eur Urol. 2007;52(5):1465–71.PubMedCrossRefGoogle Scholar
  5. Furuya Y, Akakura K, Tobe T, Ichikawa T, Igarashi T, Ito H. Changes in serum prostate-specific antigen following prostatectomy in patients with benign prostate hyperplasia. Int J Urol. 2000;7(12):447–51.PubMedCrossRefGoogle Scholar
  6. Geavlete B, Stanescu F, Iacoboaie C, Geavlete P. Bipolar plasma enucleation of the prostate vs open prostatectomy in large benign prostatic hyperplasia cases—a medium term, prospective, randomized comparison. BJU Int. 2013;111(5):793–803.PubMedCrossRefGoogle Scholar
  7. Geavlete B, Bulai C, Ene C, Checherita I, Geavlete P. Bipolar vaporization, resection, and enucleation versus open prostatectomy: optimal treatment alternatives in large prostate cases? J Endourol. 2015;29(3):323–31.PubMedCrossRefGoogle Scholar
  8. Gilling PJ, Kennett K, Das AK, et al. Holmium laser enucleation of the prostate (HoLEP) combined with transurethral tissue morcellation: an update on the early clinical experience. J Endourol. 1998;12(5):457–9.PubMedCrossRefGoogle Scholar
  9. Gratzke C, Bachmann A, Descazeaud A, Drake MJ, Madersbacher S, Mamoulakis C, Oelke M, Tikkinen KA, Gravas S. EAU guidelines on the assessment of non-neurogenic male lower urinary tract symptoms including benign prostatic obstruction. Eur Urol. 2015;67(6):1099–109.PubMedCrossRefGoogle Scholar
  10. Hiraoka Y, Akimoto M. Transurethral enucleation of benign prostatic hyperplasia. J Urol. 1989;142(5):1247–50.PubMedCrossRefGoogle Scholar
  11. Kim SH, Yang HK, Lee HE, Paick JS, Oh SJ. HoLEP does not affect the overall sexual function of BPH patients: a prospective study. Asian J Androl. 2014;16(6):873–7.PubMedPubMedCentralCrossRefGoogle Scholar
  12. Liu CX, Xu AB, Zheng SB, Li HL. Real endo-enucleation of prostate for treatment of benign prostatic hyperplasia. J Urol. 2006;(Suppl. 17):453.Google Scholar
  13. Liu C, Zheng S, Li H, et al. Transurethral enucleation and resection of prostate in patients with benign prostatic hyperplasia by plasma kinetics. J Urol. 2010;184(6):2440–5.PubMedCrossRefGoogle Scholar
  14. Mebust WK, Holtgrewe HL, Cockett AT, et al. Transurethral prostatectomy: immediate and postoperative complications. A cooperative study of 13 participating institutions evaluating 3,885 patients. J Urol. 1989;141(2):243–7.PubMedCrossRefGoogle Scholar
  15. Mishriki SF, Grimsley SJ, Lam T, Nabi G, Cohen NP. TURP and sex: patient and partner prospective 12 years follow-up study. BJU Int. 2012;109(5):745–50.PubMedCrossRefGoogle Scholar
  16. Neill MG, Gilling PJ, Kennett KM, et al. Randomized trial comparing holmium laser enucleation of prostate with plasmakinetic enucleation of prostate for treatment of benign prostatic hyperplasia. Urology. 2006;68(5):1020–4.PubMedCrossRefGoogle Scholar
  17. Palaniappan S, Kuo TL, Cheng CW, Foo KT. Early outcome of transurethral enucleation and resection of prostate compared with transurethral resection of the prostate. Singap Med J. 2016;57(12):676–80.CrossRefGoogle Scholar
  18. Shah HN, Sodha HS, Kharodawala SJ, et al. Influence of prostate size on the outcome of holmium laser enucleation of the prostate. BJU Int. 2008;101(12):1536–41.PubMedCrossRefGoogle Scholar
  19. Shimizu Y, Hiraoka Y, Iwamoto K, Takahashi H, Abe H, Ogawa H. Is complete resection of hypertrophic adenoma of the prostate possible with TURP? J Nippon Med Sch. 2005;72(3):146–8.PubMedCrossRefGoogle Scholar
  20. da Silva RD, Bidikov L, Michaels W, Gustafson D, Molina WR, Kim FJ. Bipolar energy in the treatment of benign prostatic hyperplasia: a current systematic review of the literature. Can J Urol. 2015;22(Suppl 1):30–44.PubMedGoogle Scholar
  21. Walz J, Graefen M, Huland H. Basic principles of anatomy for optimal surgical treatment of prostate cancer. World J Urol. 2007;25(1):31–8.PubMedCrossRefGoogle Scholar
  22. Walz J, Burnett AL, Costello AJ, Eastham JA, Graefen M, Guillonneau B, Menon M, Montorsi F, Myers RP, Rocco B, et al. A critical analysis of the current knowledge of surgical anatomy related to optimization of cancer control and preservation of continence and erection in candidates for radical prostatectomy. Eur Urol. 2010;57(2):179–92.PubMedCrossRefGoogle Scholar
  23. Walz J, Epstein JI, Ganzer R, Graefen M, Guazzoni G, Kaouk J, Menon M, Mottrie A, Myers RP, Patel V, et al. A critical analysis of the current knowledge of surgical anatomy of the prostate related to optimisation of cancer control and preservation of continence and erection in candidates for radical prostatectomy: an update. Eur Urol. 2016;70(2):301–11.PubMedCrossRefGoogle Scholar
  24. Xu YW, Liu CX, Zheng SB, Li HL, Fang P, Chen BS, Xu K, Shen HY. Transurethral enucleation of the prostate for treatment of benign prostatic hyperplasia in patients less than 50 years old. Nan Fang Yi Ke Da Xue Xue Bao. 2010;30(12):2708–10.PubMedGoogle Scholar
  25. Xu A, Zou Y, Li B, et al. A randomized trial comparing diode laser enucleation of the prostate with plasmakinetic enucleation and resection of the prostate for the treatment of benign prostatic hyperplasia. J Endourol. 2013;27(10):1254–60.PubMedCrossRefGoogle Scholar
  26. Xu AB, Luo F, Zou ZH, Du W, Zhao PP, Liu CX. Application of morcellator in transurethral bipolar plasmakinetic anatomical enucleation of the prostate. Nan Fang Yi Ke Da Xue Xue Bao. 2016;36(8):1100–4.PubMedGoogle Scholar
  27. Xu P, Xu A, Chen B, et al. Bipolar transurethral enucleation and resection of the prostate: whether it is ready to supersede TURP? Asian J Urol. 2018;5(1):48–54.PubMedCrossRefGoogle Scholar
  28. Zhao Z, Zeng G, Zhong W, Mai Z, Zeng S, Tao X. A prospective, randomised trial comparing plasmakinetic enucleation to standard transurethral resection of the prostate for symptomatic benign prostatic hyperplasia: three-year follow-up results. Eur Urol. 2010;58(5):752–8.PubMedCrossRefGoogle Scholar
  29. Zhu L, Chen S, Yang S, Wu M, Ge R, Wu W, Liao L, Tan. Electrosurgical enucleation versus bipolar transurethral resection for prostates larger than 70 ml: a prospective, randomized trial with 5-year followup. J Urol. 2013;189(4):1427–31.PubMedCrossRefGoogle Scholar
  30. Zong HT, Peng XX, Yang CC, Zhang Y. The impact of transurethral procedures for benign prostate hyperplasia on male sexual function: a meta-analysis. J Androl. 2012;33(3):427–34.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Chunxiao Liu
    • 1
  • Abai Xu
    • 1
  • Peng Xu
    • 1
  1. 1.Department of UrologyZhujiang Hospital, Southern Medical UniversityGuangzhouChina

Personalised recommendations