Introduction. The increasing incidence of benign prostatic hyperplasia (BPH), including giant cases, demonstrates a growing need for reliable, safe, and effective surgical treatment methods.
Study objective: to evaluate the potential of plasma-assisted transurethral enucleation of the prostate (TUEB) in the surgery of giant BPH.
Materials and methods. This randomized, controlled study included 100 patients undergoing surgery for BPH ≥250 cm3 using the TUEB method. Key outcome measures included operative time, blood loss, resection volume, hospital stay, early and late complications, and changes in urinary parameters and quality of life.
Results. Compared with the standard treatment for BPH >80 cm3 – open transvesical prostatectomy – the following results were found: operative blood loss was reduced by 2.5 times, blood transfusions by 12 times, bladder catheterization time by 3.8 times, early complications by 2.5 times, late complications by 1.5 times, repeat surgeries by 4 times, and hospitalization time by 1.5 times. The most common complications were intraoperative microtrauma of the surgical site (13%), early macrohematuria (16%), and delayed incomplete urinary continence (9%). The established correlation between resection volume and operative time, based on the results of an indepth analysis of cases with a significant increase in surgical duration, is interpreted as clinically insignificant.
Conclusion. For patients with giant BPH and a complicated urological and intercurrent medical history, TUEB has proven to be a safe and highly effective method for completely relieving symptoms of bladder outlet obstruction.
