Enucleation Might Be Better Option for Men With Benign Prostatic Hyperplasia

By Will Boggs MD

April 01, 2019

NEW YORK (Reuters Health) - Enucleation might be a better option than resection of the prostate for men with benign prostatic hyperplasia (BPH), according to a new meta-analysis.

"Although the operative time favored the resection group, the technique of enucleation was preferable due to its more favorable profile, defined by the better efficacy and less severity of adverse events and early complications," Dr. Xiaming Liu from Tongji Medical College, Huazhong University of Science and Technology, in Wuhan, China told Reuters Health by email.

Dr. Liu's team compared the efficacy and safety of transurethral enucleation and resection of the prostate for the treatment of BPH in their meta-analysis of 31 publications involving 26 randomized controlled trials with a total of 3,283 patients.

Overall, International Prostate Symptom Scores (IPSS) at one, three, six and 24 months did not differ significantly between enucleation and resection. At 12 months postoperatively, enucleation showed slightly better IPSS than resection.

Maximal urinary flow rates followed a similar pattern, and there were no significant differences between the groups in quality of life assessments or in erectile function, the researchers report in Prostate Cancer and Prostatic Diseases, online February 28.

Operation times averaged 11.14 minutes for resection and ranged from 12.60 minutes to 27.70 minutes with different enucleation techniques.

The duration of hospital stay averaged about one day shorter in the enucleation group than in the resection group, a significant difference.

There were no differences between the groups in the frequencies of grade I and IV complications, but grade II and III complications occurred significantly less frequently in the enucleation group.

These findings "could be used as a reference when urologists choose enucleative or resective techniques for BPH," Dr. Liu said. "Considering the advantages of efficacy and safety, urologists should try enucleative techniques."

SOURCE: https://bit.ly/2UBtful

Prostate Cancer Prostatic Dis 2019.