V3-09: BipoVEP - Bipolar Vapoenucleation of the prostate. Step-by-step video and early outcome
Despite high cost of investment, laser enucleation of the prostate is challenging not only standard TUR-P but also open prostatectomy as a size independent transurethral approach for surgical treatment of BPO. Due to the excellent clinical outcome of transurethral enucleation, less expensive alternatives, e.g. using bipolar electro-current are of great interest.
The presented video shows the step-by-step technique and immediate outcome of a newly developed button-type bipolar electrode to be used in combination with a mechanical tissue morcellator for bipolar vapoenucleation of the prostate. The procedure is divided into ten steps. Each step is explained in detail, covering the complete procedure from the first incision until tissue morcellation.
Up to now, 10 patients have been treated with this recently developed bipolar enucleation-electrode. Mean patients age was 74 years, the volume of the prostate 50 cc and the resected tissue 42 grams on average, leading to a volume reduction of 84%. The mean hospital stay was 2.2 days, with significant improvement of Qmax and PVR as compared to preoperative measurements. No severe adverse events have been recorded so far. Urinary tract infection caused prolonged postoperative stay in one patient.
Despite small study group size, bipolar transurethral enucleation with mechanical morcellation is feasible with this newly designed enucleation-electrode and may be a potential alternative to laser enucleation or resection of the prostate.