Results of introduction of new methods of transurethral bipolar endosurgery in the treatment of benign prostatic hyperplasia

Kononov Pavel Alekseevich, Kurnakov Anton Mihajlovich

New methods of transurethral bipolar surgery for the treatment of patients with benign prostatic hyperplasia (BPH) have been introduced in the urology Department of the Russian Railways Road hospital in Saint Petersburg since 2018. With prostate volumes up to 80 cm3, bipolar transurethral resection (BTUR) is performed, and over 80 cm3 – bipolar transurethral enucleation of the prostate (TUEB). 114 patients were selected for the study, divided into groups according to the methods of surgery. The main groups consisted of 29 patients operated by the BTUR method, and 27 by the TUEB method. The control groups included 27 patients operated by the method of monopolar TUR (MTUR), and 31 – by the method of open transvesical adenomectomy (OAE), performed in similar clinical situations before the introduction of new surgical methods in the Department. Comparison with the control showed a significant reduction in blood loss during surgery, the duration of postoperative catheterization of the bladder, the frequency of hemorrhagic and infectious complications, as well as the number of postoperative bed days for bipolar methods. A decrease in the frequency of delayed obstructive complications was also observed for BTUR in comparison with MTUR. The postoperative dynamics of urological indicators for all groups was positive, but the examination of patients 1 month after BTUR and TUEB showed a faster recovery of impaired urination parameters. This study allowed us to evaluate the implementation and recommend it to other urological hospitals in order to improve the quality of surgical care for patients with BPH and save costs by reducing the postoperative bed day.

Keywords:benign hyperplasia of the prostate, bipolar transurethral resection and enucleation of the prostate.