The Initial Clinical Experience of a New Generation Bipolar Electrosurgical and Morcellator Unit for Bipolar Transurethral Enucleation of the Prostate

Main Article Content

Ka Lun Lo
Kevin Lim
Siu Fai Ma
David Leung
Joseph K.M. Li
Siu King Mak
Hon Ming Wong
Chi Fai Ng


Background and Objective

To assess the feasibility and safety of performing bipolar transurethral enucleation of the prostate (BIPO-LEP) with a new generation of bipolar electrosurgical and morcellator system.

Material and Methods

Forty-five consecutive patients scheduled for endoscopic surgery for benign prostatic obstruction were pro-spectively recruited. BIPOLEP was performed with the use of the third generation Karl Storz AUTOCON III 400 and morcellator unit. All patients had a trial without a catheter on Day-1 after surgery. Demographical, preoperative, intraoperative and follow-up data up to 3 months post-surgery were collected and analyzed.



Between May 2018 and April 2019, 45 consecutive patients underwent BIPOLEP in our institution were prospectively recruited for this study. The mean age was 76 years old. Thirty-four patients (75.6%) were in refractory retention or obstructive uropathy. The mean enucleation efficiency was 1.76 grams per minute of enucleation time (SD = 0.7 gram per minute). The mean bladder irrigation and catheterization times were 5.3 hours and 20.7 hours respectively. Only one patient failed voiding trial on Day-1 after surgery. The postoperative Day-1 discharge rate was 73.3% (n = 33). The median length of hospital stay was 1 day. No patient required clot evacuation or blood transfusion. Seven patients (15.6%) were readmitted within thirty days postoperatively for complications, due to hematuria (8.9%, n = 4) and febrile urinary tract infection (6.7%, n = 3). Nevertheless, none was readmitted for acute urinary retention.


The use of a new generation of bipolar electrosurgical and morcellator unit for BIPOLEP was safe and the majority could be discharged without catheter within one day after surgery.



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How to Cite
Lo, K. L., Lim, K., Ma, S. F., Leung, D., Li, J. K., Mak, S. K., Wong, H. M., & Ng, C. F. (2020). The Initial Clinical Experience of a New Generation Bipolar Electrosurgical and Morcellator Unit for Bipolar Transurethral Enucleation of the Prostate. Journal of Endoluminal Endourology, 3(1), e47-e56.
Original Article


1. EAU Guidelines on the Management of Non-neurogenic Male LUTS. 2019. Available at: guideline/treatment-of-non-neurogenic-male-luts/#5.
2. Geavlete B, Stanescu F, Iacoboaie C, Geavlete P. Bipolar plasma enucleation of the prostate vs open prostatec-tomy in large benign prostatic hyperplasia cases - a medium term, prospective, randomized comparison. BJU Int 2013 May;111(5):793–803. doi: 10.1111/j.1464-410X.2012.11730. x.
3. Giulianelli R, Gentile B, Albanesi L, et al. Bipolar button transurethral enucleation of prostate in benign prostate hypertrophy treatment: a new surgical tech-nique. urology. 2015 Aug;86(2):407–13. doi: 10.1016/j. urology.2015.03.045.
4. Kawamura Y, Tokunaga M, Hoshino H, et al. Clinical outcomes of transurethral enucleation with bipolar for benign prostatic hypertrophy. Tokai J Exp Clin Med. 2015 Dec 20;40(4):132–6.
5. Wei Y, Xu N, Chen SH, et al. Bipolar transurethral enucleation and resection of the prostate versus bipolar resection of the prostate for prostates larger than 60gr: A retrospective study at a single academic tertiary care centre. Int Braz J Urol 2016 Jul-Aug;42(4):747–56. doi: 10.1590/S1677-5538.IBJU.2015.0225.
6. Abou-Taleb A, El-Shaer W, Kandeel W, et al. Bipolar plasmakinetic enucleoresection of the prostate: our experience with 245 patients for 3 years of follow-up. J Endourol 2017 Mar;31(3):300–306. doi:10.1089/ end.2016.0746.
7. Mu X, Wang S, Chen J, et al. Bipolar transurethral enucleation of prostate versus photoselective vapori-zation for symptomatic benign prostatic hyperplasia (>70 ml). Asian J Androl 2017;19(5): 608–12. doi: 10.4103/1008-682X.178484.
8. Hirasawa Y, Kato Y, Fujita K. Transurethral enucleation with bipolar for benign prostatic hyperplasia: 2-year outcomes and the learning curve of a single surgeon’s experience of 603 consecutive patients. J Endourol 2017 Jul;31(7):679–85. doi: 10.1089/end.2017.0092.
9. Xu P, Xu A, Chen B, et al. Bipolar transurethral enuclea-tion and resection of the prostate: Whether it is ready to supersede TURP? Asian J Urol 2018 Jan;5(1):48–54. doi: 10.1016/j.ajur.2017.12.001.
10. Li K, Wang D, Hu C, et al. A novel modification of transurethral enucleation and resection of the prostate in patients with prostate glands larger than 80 ml: sur-gical procedures and clinical outcomes. Urology 2018 Mar; 113:153–59. doi: 10.1016/j.urology.2017.11.036.
11. Zou Z, Xu A, Zheng S, et al. Dual-centre randomized-controlled trial comparing transurethral endoscopic enucleation of the prostate using diode laser vs. bipolar plasmakinetic for the treatment of LUTS secondary of benign prostate obstruction: 1-year follow-up results.
World J Urol 2018 Jul;36(7):1117–26. doi: 10.1007/ s00345-018-2229-3.
12. Chiruvella M, Enganti B, Bendigeri MT, et al. Transure-thral enucleation with bipolar energy (TUEB): AINU technique and short-term outcomes. Urology 2018 Dec; 122:147–51. doi: 10.1016/j.urology.2018.09.001.
13. Bardram L, et al. Recovery after laparoscopic colonic surgery with epidural analgesia, and early oral nutri-tion and mobilisation. Lancet 1995; 345:763–64. doi: 10.1016/S0140-6736(95)90643-6.
14. Liu C, Zheng S, Li H, Xu K. Transurethral enuclea-tion and resection of prostate in patients with benign prostatic hyperplasia by plasma kinetics. J Urol 2010 Dec;184(6):2440–5. doi: 10.1016/j.juro.2010.08.037. Epub 2010 Oct 16.
15. Rassweiler J1, Schulze M, Stock C, et al. Bipolar transurethral resection of the prostate--technical modi-fications and early clinical experience. Minim Invasive Ther Allied Technol 2007;16(1):11–21.
16. Talic RF. Transurethral electrovaporization-resection of the prostate using the “wing” cutting electrode: Pre-liminary results of safety and efficacy in the treatment of men with prostatic outflow obstruction. Urology 1999;53(1):106–10. doi:10.1016/S0090-4295(98)00437-3.