Background: Bipolar transurethral enucleation and resection of the prostate in saline has recently been considered as a safe and technically feasible endoscopic procedure for symptomatic benign prostatic hyperplasia. However, it has not been accepted widely because of the perception of technical difficulty. Methods: A retrospective data review was performed of the first consecutive 100 patients who had undergone bipolar transurethral enucleation and resection of prostatic adenoma. Operative outcome, complications, ratio of conversion to conventional transurethral resection of the prostate and efficiency of tissue enucleation and resection were used to assess the learning curve. Results: Bipolar transurethral enucleation and resection of the prostate was successfully performed in 83 patients. The mean operative time was 117.5 min, and the mean indwelling catheterization was 3.3 ± 1.9 days. After 6 months, maximum urinary flow was 21.34 ± 4.09 ml/s, IPSS was 9.66 ± 2.64, and quality of life was 2.31 ± 0.92 with a residual prostate volume of 35.29 ± 17.57 ml. Regarding the learning curve, the ratio of conversion to conventional bipolar transurethral resection of the prostate decreased after 30 cases, and the efficiency of enucleation and resection increased significantly with accumulative experience after 50 cases. Conclusions: The current results established that bipolar transurethral enucleation and resection of the prostate in saline is a safe and reproducible procedure.

1.
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: 3-year follow-up results. Eur Urol 2010;58:752–758.
2.
Liu C, Zheng S, Li H, Xu K: Transurethral enucleation and resection of prostate in patients with benign prostatic hyperplasia by plasma kinetics. J Urol 2010;184:2440–2445.
3.
Liao N, Yu J: A study comparing plasmakinetic enucleation with bipolar plasmakinetic resection of the prostate for benign prostatic hyperplasia. J Endourol 2012;26:884–888.
4.
Galanakis IP, Celia A, Del Biondo D, Zeccolini G, Caruso A, Silvestre P, Giunta A, Breda G: Evolving transurethral resection of the prostate: enucleation-resection of the prostate. J Endourol 2010;24:2043–2046.
5.
Gilling PJ, Kennett KM, Fraundorfer MR: Holmium laser enucleation of the prostate for glands larger than 100 g: an endourologic alternative to open prostatectomy. J Endourol 2000;14:529–531.
6.
Hochreiter WW, Thalmann GN, Burkhard FC, Studer UE: Holmium laser enucleation of the prostate combined with electrocautery resection: the mushroom technique. J Urol 2002;168:1470–1474.
7.
Ho HS, Cheng CW: Bipolar transurethral resection of prostate: a new reference standard? Curr Opin Urol 2008;18:50–55.
8.
Mamoulakis C, Trompetter M, de la Rosette J: Bipolar transurethral resection of the prostate: the ‘golden standard’ reclaims its leading position. Curr Opin Urol 2009;19:26–32.
9.
Neill MG, Gilling PJ, Kennett KM, Frampton CM, Westenberg AM, Fraundorfer MR, Wilson LC: Randomized trial comparing holmium laser enucleation of prostate with plasmakinetic enucleation of prostate for treatment of benign prostatic hyperplasia. Urology 2006;68:1020–1024.
10.
Placer J, Gelabert-Mas A, Vallmanya F, Manresa JM, Menendez V, Cortadellas R, Arango O: Holmium laser enucleation of prostate: outcome and complications of self-taught learning curve. Urology 2009;73:1042–1048.
11.
Shah HN, Mahajan AP, Sodha HS, Hegde S, Mohile PD, Bansal MB: Prospective evaluation of the learning curve for holmium laser enucleation of the prostate. J Urol 2007;177:1468–1474.
12.
Dusing MW, Krambeck AE, Terry C, Matlaga BR, Miller NL, Humphreys MR, Gnessin E, Lingeman JE: Holmium laser enucleation of the prostate: efficiency gained by experience and operative technique. J Urol 2010;184:635–640.
13.
Mamoulakis C, Ubbink DT, de la Rosette JJ: Bipolar versus monopolar transurethral resection of the prostate: a systematic review and meta-analysis of randomized controlled trials. Eur Urol 2009;56:798–809.
14.
Michielsen DPJ, Coomans D, Braeckman JG, Umbrain V: Bipolar transurethral resection in saline: the solution to avoid hyponatraemia and transurethral resection syndrome. Scand J Urol Nephrol 2010;44:228–235.
15.
Seki N, Mochida O, Kinukawa N, Sagiyama K, Naito S: Holmium laser enucleation for prostatic adenoma: analysis of learning curve over the course of 70 consecutive cases. J Urol 2003;170:1847–1850.
16.
Herrmann T, Bach T, Imkamp F, Georgiou A, Burchardt M, Oelke M, Gross A: 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;28:45–51.
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