Comparative Analysis of the Efficacy of Transurethral Enucleation of the Prostate Using Bipolar Energy according to Prostate Size in Patients with Benign Prostatic Hyperplasia

Background: To determine whether preoperative prostate volume affects the operative performance and clinical outcomes of transurethral enucleation of the prostate using bipolar energy (TUEB) in patients with benign prostatic hyperplasia (BPH).Methods: Medical records of patients who underwent TUEB for BPH between January 2019 and December 2023 at the National Medical Center were retrospectively reviewed.All procedures were performed by a single surgeon.Patients were stratified by prostate volume measured by transrectal ultrasonography into ≤50 g and >50 g groups.Enucleated tissue weight, enucleation time, surgical efficiency, and postoperative functional outcomes were evaluated.Results: Fifty-three patients were included: 23 in the ≤50 g group and 30 in the >50 g group.The >50 g group had greater enucleated tissue weight and longer enucleation time than the ≤50 g group (both P<0.001).Surgical efficiency was numerically higher in the >50 g group but did not differ significantly between groups (0.324±0.107 vs. 0.291±0.081g/min, P=0.216).Both groups showed significant postoperative improvements in urinary symptoms and voiding parameters.Conclusion: Larger prostate volume was associated with greater tissue removal and longer enucleation time, but no significant difference in surgical efficiency according to prostate size was identified.TUEB provided favorable functional outcomes across prostate volumes.Larger prospective studies are needed to confirm these findings.