[Apical breakthrough enucleation with lobar resection for the treatment of large-volume benign prostatic hyperplasia].

Authors

Zhaofei Liu, Haitao Zhang, Jun Ouyang, Xiangjun Xu, Pengfei Mao, Fei Wang, Yongbin Huang, Heng Wang

Published in

Zhonghua nan ke xue = National journal of andrology. Volume 31. Issue 12. Pages 1082-1086.

Abstract

Objective To explore the safety and efficacy of apical breakthrough enucleation with lobar resection in the treatment of large-volume benign prostatic hyperplasia (BPH). Methods A retrospective analysis was conducted on 90 BPH patients with prostate volume >80 mL admitted to the Urology Department of Lianyungang Affiliated Hospital of Nanjing University of Chinese Medicine from March 2021 to March 2025. The patients in control group (43 cases) underwent conventional transurethral plasmakinetic resection of the prostate (PKRP). And in the observation group (47cases), apical breakthrough enucleation with lobar resection was performed. The surgical outcomes (operation time, intraoperative blood loss, resected prostate weight), postoperative recovery (indwelling catheter duration, bladder residual urine volume ［BVR］, maximum urinary flow rate ［Qmax］), postoperative complications (infection, massive hemorrhage, stress urinary incontinen［SUI］), and International Prostate Symptom Score (IPSS) were compared between the two groups. Results There was no statistically significant difference in operation time between the two groups（P>0.05）. The observation group showed better results in intraoperative blood loss（［12.26±4.18］g/L vs ［15.53±4.22］g/L） and indwelling catheter duration（［3.66 ± 0.87］d vs ［5.63 ± 0.69］　d） compared to the control group (P<0.01). The resected prostate tissue volume in the observation group was significantly larger than that in the control group (［47.06±4.32］g vs ［40.76±5.99］g， P<0.01). There was no statistically significant difference in the incidence of SUI between the two groups (10.64% vs 6.98%， P>0.05). After 6 months of postoperative follow-up, there was no significant difference in IPSS and BVR between the two groups (P>0.05), but the Qmax in the observation group was significantly higher than that in the control group (［22.23±2.42］mL/s vs ［20.33±2.12］mL/s， P<0.01). Conclusion Compared with PKRP, apical breakthrough enucleation with lobar resection is equally safe but more effective in the treatment of large-volume BPH, making it an ideal therapeutic option.

PMID:
43001712
Bibliographic data and abstract were imported from PubMed on 09 Nov 2026.

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