TY - JOUR
T1 - The early learning curve of the bipolar enucleation of the prostate
T2 - a multicenter cohort study
AU - Ramesmayer, Christian
AU - Deininger, Susanne
AU - Pyrgidis, Nikolaos
AU - Lusuardi, Lukas
AU - Kunit, Thomas
AU - Pallauf, Maximilian
AU - Sieberer, Manuela
AU - Drerup, Martin
AU - Fontanella, Paolo
AU - Oswald, David
AU - Hermann, Thomas Rw
AU - Symeonidis, Evangelos N
AU - Memmos, Dimitrios
AU - Sountoulides, Petros
N1 - Ramesmayer, Deininger, Lusuardi, Kunit, Pallauf, Sieberer, Drerup, Fontanella, Oswald, Sountouides: Department of Urology and Andrology, Paracelsus Medical
University, Müllner Hauptstraße 48, Salzburg 5020, Austria; Drerup: Lehr-KH: Department of Urology, Hospital Brothers of St. John,
Kajetanerplatz 1, Salzburg, Austria
PY - 2024/8/8
Y1 - 2024/8/8
N2 - OBJECTIVES: To evaluate the early learning curve of BipolEP (Bipolar Enucleation of the Prostate).SUBJECTS/PATIENTS AND METHODS: We conducted a retrospective, multicenter analysis of surgical and functional outcomes of patients treated with BipolEp for BPO (benign prostatic obstruction). We evaluated the first 20 cases of BipolEp performed by four different surgeons in three different countries. The following baseline parameters were obtained: age, IPSS, indwelling catheter, transrectal measured prostate volume, post void residual volume (PVR) and uroflowmetry. The learning curve was analysed based on perioperative parameters and the influence of perioperative parameters was correlated with the sequence of BipolEp cases.RESULTS: 84 BipolEp operations performed by 4 different surgeons in their early learning curve were studied. Mean prostate volume was 75 ml, 39% of cases had an indwelling catheter and the average operating time was 101 min. Three out of four surgeons performed at least 50% of successful operations according to Trifecta (complete enucleation and morcellation < 90 min., no conversion to TUR-P). Conversion rate to TURP was 11.9% in total which however was driven by a single surgeon with an almost 50% conversion rate. Mean enucleated prostate was 33.3 gr (18-54.5). Intraoperative complications and reported stress incontinence ranged from 0 to 38.1%. At six-weeks review, the IPPS improved by 12.5 (8-16) points and Qmax by 208% (109.8-266.7). Uroflowmetry outcomes correlated with the sequence of cases with a linear improvement during 20 consecutive cases (p = 0.018) in all centres. Major complications (Clavien Dindo ≥ 3) were rare (4.8%) and comparable between the groups.CONCLUSION: Surgeons starting to learn BipolEp can expect to be able to achieve a linear improvement in Uroflow at the six-week postoperative evaluation after 20 consecutive cases. BipolEp can be successfully performed during the early learning curve with an acceptable rate of conversion to standard TUR-P.
AB - OBJECTIVES: To evaluate the early learning curve of BipolEP (Bipolar Enucleation of the Prostate).SUBJECTS/PATIENTS AND METHODS: We conducted a retrospective, multicenter analysis of surgical and functional outcomes of patients treated with BipolEp for BPO (benign prostatic obstruction). We evaluated the first 20 cases of BipolEp performed by four different surgeons in three different countries. The following baseline parameters were obtained: age, IPSS, indwelling catheter, transrectal measured prostate volume, post void residual volume (PVR) and uroflowmetry. The learning curve was analysed based on perioperative parameters and the influence of perioperative parameters was correlated with the sequence of BipolEp cases.RESULTS: 84 BipolEp operations performed by 4 different surgeons in their early learning curve were studied. Mean prostate volume was 75 ml, 39% of cases had an indwelling catheter and the average operating time was 101 min. Three out of four surgeons performed at least 50% of successful operations according to Trifecta (complete enucleation and morcellation < 90 min., no conversion to TUR-P). Conversion rate to TURP was 11.9% in total which however was driven by a single surgeon with an almost 50% conversion rate. Mean enucleated prostate was 33.3 gr (18-54.5). Intraoperative complications and reported stress incontinence ranged from 0 to 38.1%. At six-weeks review, the IPPS improved by 12.5 (8-16) points and Qmax by 208% (109.8-266.7). Uroflowmetry outcomes correlated with the sequence of cases with a linear improvement during 20 consecutive cases (p = 0.018) in all centres. Major complications (Clavien Dindo ≥ 3) were rare (4.8%) and comparable between the groups.CONCLUSION: Surgeons starting to learn BipolEp can expect to be able to achieve a linear improvement in Uroflow at the six-week postoperative evaluation after 20 consecutive cases. BipolEp can be successfully performed during the early learning curve with an acceptable rate of conversion to standard TUR-P.
KW - Humans
KW - Male
KW - Learning Curve
KW - Retrospective Studies
KW - Aged
KW - Prostatic Hyperplasia/surgery
KW - Middle Aged
KW - Prostatectomy/methods
KW - Cohort Studies
KW - Treatment Outcome
KW - Aged, 80 and over
U2 - 10.1007/s00345-024-05183-y
DO - 10.1007/s00345-024-05183-y
M3 - Original Article
C2 - 39115714
SN - 0724-4983
VL - 42
SP - 478
JO - WORLD JOURNAL OF UROLOGY
JF - WORLD JOURNAL OF UROLOGY
IS - 1
M1 - 478
ER -