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#23236

Five-Year Outcomes with Transurethral Bipolar Enucleation of Prostate (TUBE): Rapid Adoption and Familiarity with Instrumentation Makes TUBE a Viable Alternative to Holmium Enucleation (HOLEP) in those Unable or Unwilling to Endure the HOLEP Learning Curve Tully Z1, Barnes B1, Erickson B1 1. University of Iowa, Carver College of Medicine, Department of Urology KEYWORDS: Surgery, Benign Prostatic Hyperplasia (BPH), Bladder Outlet Obstruction , Voiding Dysfunction Transurethral enucleation procedures for benign prostatic hyperplasia (BPH) can effectively remove large volumes of prostatic tissue comparable to open simple prostatectomy. The most common enucleation procedure is the Holmium Laser Enucleation (HOLEP), but the learning curve is steep and has, thus, not been widely adopted (1). The senior author in this study - a non-fellowship (HOLEP)-trained urologist - was asked to learn HOLEPs, but quickly abandoned them after approximately 6 months and 15 HOLEP procedures when operative times and surgical outcomes were not improving satisfactorily relative to their standard transurethral resection (TURP) experience. Wanting to continue enucleations, however, the enucleation principles were incorporated into more familiar resection bipolar devices, first using the bipolar button (Olympus) electrode and later the plasma button (Olympus). The primary anecdotal advantages expressed by the senior author were 1) immediate familiarity with the instrumentation, 2) ability to use enucleation and traditional resection techniques interchangeably and 3) the ability to perform antegrade and retrograde manipulation of the prostatic tissue during blunt dissection and adenoma enucleation. The purpose of this study is to review our 5-year experience with transurethral bipolar enucleation of the prostate (TUBE). We hypothesized that 1) operative time would decrease and 2) resection volumes would increase over the study period and 3) surgical outcomes would be similar to those reported for standard transurethral resection (TURP) and HOLEP.