Anatomical Endoscopic Enucleation of the Prostate: An overview

Abstract

Lower urinary tract symptoms (LUTS) increase with age, primarily due to benign prostatic obstruction (BPO), affecting about 80% of men above 80 years of age with a significant impact on quality of life (QoL). Treatment varies from pharmacotherapy to surgery based on the severity of LUTS. Transurethral resection of prostate (TURP) has been considered the standard of care for surgical management of LUTS/BPO. However, in the last few decades with technological advancements and shortfalls of TURP, newer techniques for surgical treatment have emerged. These techniques score over TURP in many ways providing significant functional improvements, shorter hospital stays, and lower complication rates compared to conventional resection techniques. Advancements in laser technology and surgical approaches have established anatomical endoscopic enucleation of the prostate (AEEP) as a gold standard for benign prostatic hyperplasia (BPH) surgery. AEEP offers excellent functional outcomes, reduced bleeding risks, shorter catheterization times, and lower hospital stays, making it suitable for a wide range of patients, especially those with large prostates. Long-term functional outcomes of AEEP are superior to TURP irrespective of the technique or energies used. Future research should aim to optimize surgical techniques, explore ejaculatory-sparing approaches, and standardize outcome reporting to further solidify AEEP’s role in BPO treatment.