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Dr. Jörg Rassler performs a Transurethral Enucleation of the Prostate with Plasma to a 68 years old patient with sever syduria, nycturia 3-4 times per nigh and a PSA of 2.51.

Technique Description:

  • 1) Continuous flow resectoscope 27 F, active, 12°
  • 2) HF-Generator, bipolar 200 W cutting, 120 W coag.
  • 3) Pre-warmed NaCl solution (32°C)
  • 4) Spinal anesthesia

Procedure Steps:

  • 1) Resection of 6 o’clock channel
  • 2) Enucleation of the left lobe
  • 3) Resection of the enucleated lobe
  • 4) Enucleation and resection of the right lobe
  • 5) Trimming of the bladder neck
  • 6) Coagulation, chip removal, catheter

Learning Points:

  • Transurethral mechanical enucleation technique
  • Avoidance of morcellation
  • Anatomical landmarks
  • Prograde ejaculation preserving technique

Clinic History:

  • 68 y.o. patient
  • Severe dysuria, nycturia 3-4 times/night
  • PSA 2.51
  • BPH, failure of drug therapy (Tamsulosin)
  • Vol. 60cc, multiple calcifications esp. left lobe
  • Res. Vol. 30ml

Other History:

  • Comorbidity
  • Nephrolithiasis
Faculty keyboard_arrow_down
Dr. Jörg Rassler Head of the Dept. Urology, St. Elisabeth-Hospital, Leipzig, Germany Urology
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