BIPOLAR ENUCLEATION OF PROSTATIC HYPERPLASIA: INITIAL RESULTS IN THE SAMARKAND REGION

Abstract

Introduction. Benign prostatic hyperplasia (BPH) is one of the most common urological diseases among elderly males impacting patients’ health and quality of life. Despite significant advances in BPH pharmacotherapy, the most effective method of treating BPH is surgery. Endoscopic enucleation of the prostate (EEP) has become currently a leading surgical treatment for BPH. One of the EEP modalities is transurethral bipolar enucleation of the prostate (b-TURP).

Purpose. Evaluation of the efficacy and safety of bipolar  enucleation of the prostate (b-TURP) through the systematization of postoperative complications in patients with BPH. Initial results of b-TURP in the Samarkand region are provided.

Results. To assess postoperative complications of b-TUEP, the Clavien-Dindo classification system adapted for assessing postoperative complications of surgical methods for the treatment of BPH was used. 10 (27.8%) postoperative complications were observed in 9 (25%) patients. All registered complications were minor - I and II grade due to the adapted Clavien-Dindo classification. High efficiency of b-TUEP was indicated by positive changes of the main indicators in assessing of surgical interventions for BPH: IPSS (International Prostate Symptom Score) questionnaire, quality of life index (QoL), average urine flow rate (Qaver), prostate volume (Vpr) and residual urine volume (PVR). Three months after surgery IPSS score reduced from 23.6 before surgery to 7.3, QoL index - from 4.5 to 2.3, Qaver increased from 3.7 ml/sec to 12.6 ml/sec, Vpr reduced from 99.9 to 32.7 cm³ and PVR - from 87.6 ml to 16.9 ml.

Conclusion. b-TUEP is a modern minimally invasive transurethral method of treating BPH. Positive dynamics of the main outcomes of surgical interventions for BPH indicate the high efficiency of this method. The low level of postoperative complications, most of which are minor deviations from the normal postoperative period, indicates the safety of the procedure.