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Background Three-quarters of aged men experience lower urinary tract symptoms with benign prostate hypertrophy (BPH). Transurethral resection of the prostate (TURP) and holmium laser enucleation of the prostate (HoLEP) are standard endosurgical procedures in patients with BPH. Previous studies reported better results in patients undergoing HoLEP than in those undergoing TURP. Methods This study compared the efficiency and safety of conventional morcellation and morcellation performed after X-incision during enucleation, a newly added technique in HoLEP. Overall, 174 patients were selected as the final study population. The populations were stratified with respect to resected volumes. A t-test were used to compare the conventional morcellation and X-incision procedure groups. Results In morcellation times and rates, there were significant differences in stratified resected mass (g) between the groups. The results also showed a decreased incidence of bladder injury as a surgical complication. Conclusion We believe morcellation performed after X-incision procedure during enucleation is efficient and safe for older adults with BPH.

Background : This retrospective study examined the safety and efficacy of transurethral enucleation with bipolar energy (TUEB) for benign prostatic hyperplasia (BPH), based on initial experiences. Methods : In this study, 2 surgeons performed TUEB on 23 patients between January 2014 and April 2017. The International Prostate Symptom Score (IPSS), quality of life (QoL), digital rectal examination, transrectal ultrasonography, prostate-specific antigen (PSA) levels, maximum flow rate (Qmax), and postvoid residual urine (PVR) were used as variables. Resected prostate volume (g), resection time, efficiency of resection, change in hemoglobin, and indwelling Foley catheter duration were used to assess the efficacy of TUEB. Foley catheter reinsertion rate, occurrence of urethral or bladder neck stricture, urinary incontinence, and bladder injury were evaluated as complications of TUEB. Results : Mean age was 70.3±8.3 years. Mean prostate volume was 55.1±33.9 g. Preoperative and 1-month postoperative PSA, IPSS, QoL, Qmax, and PVR data were collected and showed significant difference. Resected prostate volume, resection time, resection efficiency, indwelling Foley catheter duration, and change in hemoglobin values were 22.9±14.7 g, 109.6±60.3 minutes, 0.23±0.13 g/min, 4.7±4.7 days, and 0.9±0.7 g/dL, respectively. Following TUEB, incontinence occurred in 2 patients and acute urinary retention in 2 (8.7%). Conclusion : Our initial experience suggests that TUEB is efficient and safe for patients with BPH. However, the study was limited by the small number of subjects.