Preperitoneal single-port transvesical enucleation of the prostate (STEP) for large-volume BPH: one-year follow-up of Qmax, IPSS, and QoL

Abstract

Objective: To evaluate the 1-year efficacy and safety of single-port transvesical enucleation of the prostate (STEP) for voluminous benign prostatic hyperplasia (BPH).

Methods: Nine patients with moderate- to large-volume (83.8 ± 19.9 mL) BPH (mean age 71.9 ± 6.39 years, body mass index [BMI] 21.5 ± 3.25 kg/m(2)) were preoperatively evaluated by abdominal and transrectal ultrasonography, uroflowmetry, International Prostate Symptom Score (IPSS) and Quality of Life Index (QoL). The STEP procedures were performed by a single surgeon. All patients were followed up for a minimum of 12 months postoperatively by ultrasonography, uroflowmetry, IPSS, and QoL.

Results: STEP was smoothly completed in 8 cases with 1 case of open conversion owing to failure of the single-port device insertion. The mean operative duration was 160.9 ± 30.24 minutes, and the estimated blood loss was 418.8 ± 282.76 mL. One intraoperative complication of bleeding occurred. Postoperative complications occurred for 2 patients, including one case each of acute epididymitis and urethral stricture. At the 12-month follow-up after surgery, the mean Q(max) of the entire cohort was 22.7 ± 4.62 mL/s (an increase of 12.9 mL/s), with an average postvoid residual volume of 36.1 ± 40.02 mL, an IPSS of 4.1 ± 1.36 (a decrease of 21 points), and a QoL of 1.4 ± 1.19 (a decrease of 3.2 points). No patients developed incontinence or bladder neck contracture.

Conclusion: In selected patients with voluminous BPH, STEP is a safe, feasible, and efficacious procedure with a promising outcome at 1-year follow-up in terms of Q(max), IPSS, and QoL.