Transurethral Enucleation and Resection of the Prostate: Contemporary Role in the Surgical Treatment of Benign Prostatic Hyperplasia

Benign prostatic hyperplasia (BPH) is a very common urological problem affecting all men as they age. Despite the rapid evolution of BPH surgical treatment, transurethral resection of the prostate (TURP) is still considered the gold standard, which has prevailed over the past century. However, due to the safety issues associated with TURP, particularly with prostates larger than 80 ml together with the limited exposure of young urologists to the open prostatectomy, many urologists sought to modify the standard TURP in a way that would assure complete removal of the adenoma with lower risk of complications. Therefore, enucleation was incorporated into the standard TURP in a procedure called transurethral enucleation and resection of the prostate (TUERP), which has been used over the past decade. Besides its ability to provide complete removal of the adenoma, the main advantage of this modification is to help define the capsular plane early during the procedure, which will reduce the risk of capsular perforation and help control bleeders in a timely manner. The technique can be performed with monopolar or bipolar energy. The current evidence proved its safety and efficacy as an alternative to TURP and open prostatectomy in treating medium to large prostate sizes. In this mini review, we discuss the contemporary role of TUERP in the surgical treatment of BPH. We believe that our review will be of great benefit to readers particularly with the rapid evolution of surgical BPH treatment.