Comparative Study between Bipolar Transurethral Resection and Bipolar Transurethral Enucleation of the Prostate for Managing Benign Prostatic Hyperplasia

Abstract

Introduction: Benign prostatic hyperplasia is considered a common disorder that occurs with advancing age inmales. The bladder outlet obstruction is the main complaint associated with this condition that could be managedwith different endoscopic approaches the traditional one is the transurethral prostatic resection and recently thetransurethral prostatic enucleation has emerged. This study aimed to compare between both techniques.Methods: This was a clinical trial performed at Ahmed Maher Teaching hospital. Patients were randomized toeither Group (1): (TUEP) patients subjected to the bipolar transurethral enucleation of prostate and Group (2):(TURP) patients subjected to the bipolar transurethral resection of the prostate. After the surgical procedures,the patients were compared regarding the success rate and the perioperative complications. Three months aftersurgery, assessment was done through uroflowmetry studies, post-voiding residual volume of urine and theInternational Prostate Symptom Score.Results: The mean duration of the procedure showed no significant differences between both groups in TUEP(82.8±8.4 min) vs (79.7±8.80 min) TURP (P=0.262). Post-operative drop of haemoglobin level was less in TUEPvs TURP (0.79±.14 vs 1.41±.42) g/dl (P=0.007), in addition to shorter time needed for catheters (46.10±10.18 vs56.65±13.14 hr; P=0.036) and less duration of hospital stay (53.70±9.13 vs 62.40±12.06 hr; P=0.001). A significantimprovement was observed between baseline and 3 months postoperatively regarding uroflowmetry (Qmax),IPSS and PVR in both groups.Conclusion: The mean operative time was nearly similar in both groups, however TUEP was associated with lessbleeding, shorter time needed for catheters, less time needed for hospital stay. After 3 month, uroflowmetry Qmax,PVR and IPSS were similar in both procedures.