{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T00:20:36Z","timestamp":1793319636284,"version":"4.5.0"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>Benign prostatic obstruction (BPO) is a common condition in aging men that often requires surgical intervention when medical therapy fails. Anatomical Endoscopic Enucleation of the Prostate (AEEP) has become an established minimally invasive treatment, with en bloc and three-lobe techniques being the most commonly used approaches. This systematic review and meta-analysis aimed to compare perioperative outcomes, surgical efficiency, and postoperative recovery between en bloc and three-lobe enucleation techniques. A comprehensive literature search was conducted in PubMed, Wiley Online Library, Scopus, Embase, SpringerLink, and the Cochrane Library for studies published up to May 2024. Eligible studies directly compared en bloc and three-lobe enucleation techniques and reported relevant perioperative and postoperative outcomes. Data were analyzed in accordance with PRISMA guidelines, and the risk of bias was assessed using the ROBINS-I tool. Six retrospective observational studies involving a total of 1,765 patients were included. En bloc enucleation was associated with a significantly shorter enucleation time compared with the three-lobe technique. No significant differences were observed in enucleation efficiency or resected prostate volume between the two techniques. Postoperative urodynamic outcomes showed slightly greater improvements in postvoid residual volume and maximum urinary flow rate with the three-lobe technique. No significant differences were found in International Prostate Symptom Score improvement or the incidence of postoperative urinary incontinence. Most included studies demonstrated a moderate risk of bias. Both en bloc and three-lobe enucleation techniques are effective and safe for the management of BPO. En bloc enucleation offers the advantage of reduced operative time, whereas the three-lobe technique may provide modestly better postoperative urodynamic outcomes. Further high-quality randomized controlled trials are required to confirm these findings and evaluate long-term outcomes.<\/jats:p>","DOI":"10.4103\/ua.ua_85_25","type":"journal-article","created":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T16:00:13Z","timestamp":1768924813000},"page":"1-9","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Efficacy and safety of en bloc versus three-lobe enucleation technique for the management of benign prostatic obstruction: A systematic review and meta-analysis"],"prefix":"10.4103","volume":"18","author":[{"given":"Andika","family":"Afriansyah","sequence":"first","affiliation":[{"name":"Department of Surgery, Division of Urology, Persahabatan General Hospital \u2013 Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiwah Andanni","family":"Bangsawan","sequence":"additional","affiliation":[{"name":"Department of Urology, Cipto Mangunkusumo Hospital \u2013 Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moammar Andar Roemare","family":"Siregar","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Urology, Persahabatan General Hospital \u2013 Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sung Yong","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Urology, Seoul National University Hospital, Seoul National University, College of Medicine, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nugroho","family":"Purnomo","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Urology, Persahabatan General Hospital \u2013 Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doddy Widyawan Hami","family":"Seno","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Urology, Persahabatan General Hospital \u2013 Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hendy","family":"Mirza","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Urology, Persahabatan General Hospital \u2013 Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,1,20]]},"reference":[{"key":"R1-20260417","first-page":"2077","article-title":"Treatment algorithm for management of benign prostatic obstruction: An overview of current techniques","volume":"13","author":"Hughes","year":"2023","journal-title":"Life 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