{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T19:01:46Z","timestamp":1771959706966,"version":"3.50.1"},"reference-count":14,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T00:00:00Z","timestamp":1769212800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:00:00Z","timestamp":1771891200000},"content-version":"vor","delay-in-days":31,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Urol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Transurethral resection of the prostate (TURP) remains the standard surgical treatment for benign prostatic hyperplasia (BPH), but its efficacy decreases in large prostates. Bipolar enucleation of the prostate (BipolEP) has been introduced as a modification enabling complete adenoma removal and potentially superior outcomes. This study compared the efficacy and safety of bipolar TURP (B-TURP) and BipolEP in patients with large prostate volumes (\u2265\u200980 mL).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and methods<\/jats:title>\n                    <jats:p>\n                      Seventy patients with prostate volume\u2009\u2265\u200980 mL and bladder outlet obstruction were prospectively randomized to undergo either B-TURP (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200937) or BipolEP (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200933). Both procedures were performed using standardized bipolar platforms. Postoperative management followed uniform bladder irrigation and catheterization protocols. Primary outcomes were functional parameters (IPSS, Qmax, PVR), while secondary outcomes included perioperative parameters and complications. ANCOVA analysis adjusting for baseline IPSS and Qmax, and Post-hoc power analysis were performed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Both groups showed significant postoperative improvement in IPSS, Qmax, and PVR (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Compared with B-TURP, BipolEP achieved a greater reduction in IPSS (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04) and higher postoperative Qmax (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004). Operative time, irrigation volume, catheterization duration, and residual tissue were all significantly lower in the BipolEP group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Retrograde ejaculation occurred more frequently after BipolEP (81.8% vs. 48.6%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004), whereas other complications were comparable. ANCOVA confirmed that between-group differences in IPSS and Qmax remained significant after adjusting for baseline values.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In patients with large prostates, BipolEP offers superior functional outcomes and improved perioperative efficiency compared with B-TURP, though at a higher risk of retrograde ejaculation. These findings support BipolEP as a preferred surgical option for large-volume BPH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>The study is registered in clinical trials (ClinicalTrials gov ID: NCT05330156 ; Registered on April 15, 2022).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12894-025-02004-1","type":"journal-article","created":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T07:54:22Z","timestamp":1769241262000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Bipolar resection versus enucleation of the prostate in management of benign prostatic hyperplasia patients with large-sized prostates: a prospective randomized controlled clinical trial"],"prefix":"10.1186","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8750-6236","authenticated-orcid":false,"given":"Mostafa M.","family":"Mostafa","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed F.","family":"Ibrahim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed M.","family":"Moeen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed A.","family":"Elgammal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed S.","family":"El-Azab","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad A.","family":"Faragallah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,1,24]]},"reference":[{"issue":"S2","key":"2004_CR1","doi-asserted-by":"publisher","first-page":"S29","DOI":"10.1089\/end.2022.0305","volume":"36","author":"MS Agrawal","year":"2022","unstructured":"Agrawal MS, Mishra DK. Transurethral resection of prostate. J Endourol. 2022;36(S2):S29\u201334.","journal-title":"J Endourol"},{"key":"2004_CR2","doi-asserted-by":"publisher","unstructured":"Vo LT, Armany D, Chalasani V, Bariol SV, Baskaranathan S, Hossack T, Ende D, Woo HH. Endoscopic enucleation of the prostate versus transurethral resection of the prostate for benign prostatic hyperplasia: a systematic review and meta-analysis. Prostate Cancer Prostatic Dis. 2025. https:\/\/doi.org\/10.1038\/s41391-025-00970-z. Epub ahead of print.","DOI":"10.1038\/s41391-025-00970-z"},{"issue":"5","key":"2004_CR3","doi-asserted-by":"publisher","first-page":"663","DOI":"10.1089\/end.2020.0840","volume":"35","author":"A Bruce","year":"2021","unstructured":"Bruce A, Krishan A, Sadiq S, Ehsanullah SA, Khashaba S. Safety and efficacy of bipolar transurethral resection of the prostate vs monopolar transurethral resection of prostate in the treatment of moderate-large volume prostatic hyperplasia: a systematic review and meta-analysis. J Endourol. 2021;35(5):663\u201373.","journal-title":"J Endourol"},{"issue":"1","key":"2004_CR4","doi-asserted-by":"publisher","first-page":"68","DOI":"10.4111\/kju.2015.56.1.68","volume":"56","author":"HJ Goh","year":"2015","unstructured":"Goh HJ, Kim SA, Nam JW, Choi BY, Moon HS. Community-based research on the benign prostatic hyperplasia prevalence rate in Korean rural area. Korean J Urol. 2015;56(1):68\u201375.","journal-title":"Korean J Urol"},{"key":"2004_CR5","doi-asserted-by":"crossref","unstructured":"Geavlete P. Is classical transurethral resection of the prostate, the gold standard endoscopic treatment for benign prostate hyperplasia, in real danger of being replaced? Eur Urol. 2010;58(3):356-8; discussion 8\u20139.","DOI":"10.1016\/j.eururo.2010.06.001"},{"issue":"4","key":"2004_CR6","doi-asserted-by":"publisher","first-page":"546","DOI":"10.1111\/j.1464-410X.2011.10770.x","volume":"110","author":"AY Muslumanoglu","year":"2012","unstructured":"Muslumanoglu AY, Yuruk E, Binbay M, Akman T. Transurethral resection of prostate with plasmakinetic energy: 100 months results of a prospective randomized trial. BJU Int. 2012;110(4):546\u20139.","journal-title":"BJU Int"},{"issue":"4","key":"2004_CR7","doi-asserted-by":"publisher","first-page":"747","DOI":"10.1590\/S1677-5538.IBJU.2015.0225","volume":"42","author":"Y Wei","year":"2016","unstructured":"Wei Y, Xu N, Chen SH, Li XD, Zheng QS, Lin YZ, 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 center. 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Singap Med J. 2011;52(10):747\u2013687514.","journal-title":"Singap Med J"}],"container-title":["BMC Urology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12894-025-02004-1","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12894-025-02004-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12894-025-02004-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T18:03:44Z","timestamp":1771956224000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12894-025-02004-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,24]]},"references-count":14,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["2004"],"URL":"https:\/\/doi.org\/10.1186\/s12894-025-02004-1","relation":{},"ISSN":["1471-2490"],"issn-type":[{"value":"1471-2490","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,24]]},"assertion":[{"value":"12 June 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 November 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 January 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Approval was obtained from the Assiut University College of Medicine Institutional Review Board (IRB number: 17200747). The authors also certify that the study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments.The nature of the study, its aim, the procedures performed, and any risk from participation in the study were explained in detail to the patients before enrolling in the study, and patients who voluntarily agreed to participate in the study signed an informed consent prior to participating in the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent for publication was obtained from patients involved in this study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"52"}}