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Anatomical endoscopic enucleation of the prostate (AEEP) is recommended as the first-line surgical treatment for benign prostatic obstruction (BPO) caused by a large prostate adenoma. However, its effectiveness in the retreatment setting after a failed previous surgical treatment for BPO is not well-established. A systematic review and meta-analysis were conducted to assess the safety and efficacy of AEEP in this context. The analysis included 15 studies involving 6,553 patients, with 841 experiencing recurrent or residual BPO and 5,712 with primary BPO. The results indicate that AEEP is equally effective in treating recurrent or residual BPO compared to primary BPO, with positive outcomes observed after previous standard or minimally invasive surgical treatments for BPO. However, the overall strength of evidence was considered very low. Therefore, in experienced hands, AEEP can be safely and effectively used to treat recurrent or residual BPO in patients with large or moderate prostates who have undergone previous surgical treatments for BPO.
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