title: Early outcome of transurethral enucleation and resection of the prostate versus transurethral resection of the prostate.
abstract: BACKGROUND
  Recurrent prostate adenoma is a long-term complication following transurethral resection of the prostate (TURP). Transurethral enucleation and resection of the prostate (TUERP) is more appealing, since the nodular adenoma can be completely removed through endoscopy. TUERP is also hypothesised to result in a lower frequency of recurrent adenoma. This study aimed to compare the early outcomes of TUERP and TURP, and assess the feasibility and safety of TUERP.
  
  
  METHODS
  We compared the outcome of 81 patients who underwent TUERP with that of 85 patients who underwent TURP. International prostate symptom score, quality of life score, prostate volume, degree of intravesical prostatic protrusion, maximum flow rate, post-void residual volume and prostate-specific antigen (PSA) level were obtained pre- and postoperatively. Complications (e.g. transfusion rate, incontinence, infection and urethral stricture) were analysed.
  
  
  RESULTS
  Operative time was significantly longer in the TUERP group compared to the TURP group (85.3 minutes vs. 51.6 minutes). After TUERP, the maximum flow rate was significantly higher (21.1 mL/s vs. 17.1 mL/s) and PSA level was significantly lower (1.2 ng/mL vs. 1.9 ng/mL) than after TURP. The rates of infection, transfusion and urethral stricture were similar for both groups, but the TUERP group had a higher rate of temporary incontinence (13.6% vs. 4.7%).
  
  
  CONCLUSIONS
  The lower PSA level and better maximum flow rate achieved following TUERP suggest that prostate adenoma removal was more complete with TUERP. Long-term follow-up is required to establish whether TUERP results in fewer resections for recurrent adenoma.
authors.affiliation: Department of Urology, Singapore General Hospital, Singapore.
authors.forename: Sundaram
authors.initials: S
authors.lastname: Palaniappan
authors.affiliation: Department of Urology, Singapore General Hospital, Singapore.
authors.forename: Tricia Li Chuen
authors.initials: TL
authors.lastname: Kuo
authors.affiliation: Department of Urology, Singapore General Hospital, Singapore.
authors.forename: Christopher Wai Sam
authors.initials: CW
authors.lastname: Cheng
authors.affiliation: Department of Urology, Singapore General Hospital, Singapore.
authors.forename: Keong Tatt
authors.initials: KT
authors.lastname: Foo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006761:Hospitals; D006801:Humans; D007902:Length of Stay; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D011467:Prostate; D017430:Prostate-Specific Antigen; D011468:Prostatectomy / Q000379:methods*; D011470:Prostatic Hyperplasia / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D012846:Singapore; D020728:Transurethral Resection of Prostate; D016896:Treatment Outcome
chemical_list: D017430:Prostate-Specific Antigen
keywords: benign prostatic hyperplasia; transurethral enucleation and resection of prostate; transurethral resection of prostate