Bipolar Transurethral Resection Of Prostate Research Articles

Risk Factors for Bladder Neck Contracture Following Transurethral Resection of the Prostate in Patients with Benign Prostatic Enlargement.

Introduction To investigate the risk factors associated with developing BNC after bipolar TURP. Methods This retrospective cohort study included patients with symptomatic BPE who underwent TURP at our institution between 2010 and 2021. Univariate and multivariate Cox regression analyses were used to evaluate the association of patient- and surgery-related factors to BNC. The preoperative urinary catheterization and resection speed with BNC were evaluated by dividing the patients into four groups as follows: (1) with or (2) without preoperative urinary catheterization and (3) high or (4) low resection speed. The risk of BNC3Y between the four groups was compared using the Kaplan-Meier analysis and log-rank tests. Results 2041 patients underwent TURP between 2010 and 2021 were enrolled. Within 3 years of surgery, 306 (15%) patients were diagnosed with BNC. COPD, congestive heart failure, preoperative urinary catheterization, and low resection speed were associated with a higher risk of BNC3Y. The Kaplan-Meier analysis and log-rank tests demonstrated an increased risk of BNC due to preoperative urinary catheterization, regardless of the resection speed. Multivariate analysis revealed that COPD and preoperative urinary catheterization were independent predictive factors for BNC. Conclusions Our study findings indicate that preoperative urinary catheterization and COPD are associated with an increased risk of BNC in patients with BPE undergoing bipolar TURP.

One-Year Outcomes of Transurethral Treatment of Bladder Neck Stenosis Following Transurethral Resection of the Prostate. Results from a Large, Multicenter Series.

To assess management and outcomes of bladder neck stenosis (BNS) post-transurethral resection of the prostate (TURP) in 12 centers. A retrospective analysis of patients who underwent transurethral BN incision for stenosis following TURP from January 2015 and January 2023 was performed. Inclusion criteria included endoscopic diagnosis of BNS associated with obstruction and/or lower urinary tract symptoms. Data are presented as median and interquartile range. Two distinct univariable logistic regression analyses were performed to identify factors associated with overall urinary incontinence and recurrent stenosis. Three hundred and seventy-two men were included. 95.2% of patients developed BNS following bipolar TURP. 21.0% of patients were on an indwelling catheter before BNS incision. Bipolar electrocautery was the most commonly employed energy for incision (66.5%). Collings knife was the most commonly employed (61.2%) instrument for incision, followed by end-firing holmium lasering (35.3%). Median operation time was 30 (25-45) minutes. The overall complication rate was 12.4%, with 19 (5.1%) patients suffering from acute urinary retention, 6 (1.6%) patients requiring prolonged irrigation due to persistent hematuria, and a surgical hemostasis was necessary in 8 cases (2.2%). Overall postoperative incontinence rate was 17.2%, with urge incontinence accounting for the most common type (45.3%). Incontinence lasted more than 3 months in 9/46 (14.3%) patients. Recurrent BNS occurred in 29 (7.8%) patients and was managed by re-endoscopic incision in 21 (5.6%) patients and dilatation only in 6 (1.6%) patients. Two (0.5%) patients underwent urethroplasty for recalcitrant stenosis. Logistic regression analysis showed that Collings knife was associated with higher odds of having postoperative incontinence (OR 3.93 95% CI 1.45-11.13, p=0.008) and BN recurrence (OR 3.589 95% CI 1.157-15.7, p=0.047). Transurethral BN incision provides satisfactory short-term results with an acceptable rate of complications.

Beware of Bipolar Transurethral Resection of Prostate in Patients with Previously Inserted Metallic Prostate Stapling Devices

Metallic prostate stapling (e.g., UroLift) is a minimally invasive treatment option for men with bladder outlet obstruction from benign prostatic hyperplasia (BPH). While it provides rapid relief and preserves sexual function, unexpected interactions with other medical devices can compromise surgical procedures. In this letter, we highlight five cases where stapled metallic implants resulted in damage to bipolar energy device during transurethral resection of the prostate (TURP) and stimulation of obturator nerve. Laser may also reflect off metallic prostate implants which can result in laser equipment malfunction. Monopolar TURP should be considered in patients with existing metallic prostate implants who need further transurethral surgery for obstructive BPH to prevent bipolar instrument damage and obturator kick.

PSA density as a predictor of long-term infectious complications during transurethral resection of the prostate: determining an optimal cut-off value

Introduction. Infectious complications (ICs) after transurethral resection of the prostate (TURP) are significant and potentially life-threatening conditions with an incidence 0.5% – 20.0%. Most publications provide data regarding early infectious complications. At the same time, there are currently no studies aimed at a comprehensive assessment of long-term infectious complications after TURP. The problem of prevention and treatment of ICs is also accompanied by insufficient understanding of the role of undiagnosed inflammation in prostate tissues and the lack of representative laboratory markers.Objective. To assess the prostate-specific antigen density (PSAd) as a predictor of long-term infectious complications after transurethral resection of the prostate and to determine the optimal cut-off value.Materials & methods. This single-center study included 162 patients who underwent mono- and bipolar TURP between 2016 – 2023. Inclusion criteria for the study: prostate volume 30–80 cm3, no history of urinary tract infections (UTIs) at the time of hospitalization and antibiotic treatment at least one month before surgery, possible presence of latent UTIs before surgery, no prostate cancer. Exclusion criteria were failure to meet inclusion criteria. Infectious complications assessed included upper and lower UTIs, as well as epididymitis, orchitis and prostatitis, confirmed by clinical and laboratory data. Prostate-specific antigen (PSA) assessment was performed < 2 days before surgery.Results. The median PSAd value was 0.04 [0.03; 0.08] ng/ml2, the variable was significantly different in non-infection and infection groups (0.04 and 0.08 ng/ml2, respectively, p = 0.009). The area under the curve (AUC) was 0.67 (95% CI [0.546 – 0.791]). The optimal cut-off value of the PSAd in prediction of long-term ICs was > 0.07 ng/ml2, sensitivity / specificity: 58.3% and 76.1%, respectively. The analysis showed more than 4 times higher odds of developing an infectious complication in PSAd > 0.07 ng/ml2 patients: OR 4.3 (95% CI [1.7 – 10.5], p = 0.001).Conclusion. This study demonstrates data that defines a new clinical non-oncological significance of PSAd as a predictor of the development of long-term infectious complications after TURP.

Prospective randomized study correlating intraoperative urethral mucosal injury with early post transurethral resection of the prostate stricture urethra: A novel concept

ObjectiveTo investigate the incidence of urethral stricture during the early period after transurethral resection of the prostate (TURP) and correlate its incidence with intraoperative urethral mucosal injury during TURP. Also to compare the other established risk factors affecting the development of urethral stricture among patients undergoing monopolar or bipolar TURP over a period of 6 months follow-up as prospective randomized study. MethodsOne hundred and fifty men older than 50 years with lower-urinary tract symptoms associated with benign prostatic hyperplasia were randomized to undergo either standard monopolar TURP with glycine as the irrigation fluid or bipolar TURP with normal saline as irrigant. Prostate size, operative time, intra-operative mucosal rupture, catheter time, catheter traction duration, uroflowmetry, and post-operative stricture rate were compared. ResultsA total of 150 patients underwent TURP, including 74 patients undergoing monopolar TURP (one patient was excluded as his post-operative histopathological examination report was of adenocarcinoma prostate) and 75 patients undergoing bipolar-TURP, all of which were performed using 26 Fr sheath resectoscope. The average International Prostate Symptom Score and maximum urinary flow rate score at post-operative 3 and 6 months were comparable between the groups. Out of 149 patients, nine patients (6.0%) developed urethral stricture. The severity of the injury (urethral mucosal injury) correlated with the likelihood of developing a subsequent complication (stricture urethra). Patients with stricture had significantly larger prostate volume than patients without stricture (65.0 mL vs. 50.0 mL; p=0.030). Patients with stricture had longer operative time than patients without stricture (55.0 min vs. 40.0 min; p=0.002). In both procedures, formation of post-operative stricture urethra was independently associated with intra-operative mucosal injury. ConclusionIntra-operative recognition of urethral mucosal injury helps in prediction of stricture urethra formation in early post-operative period.

Comparison of Bipolar and Monopolar Transurethral Resection of the Prostate, Functional Outcomes and Analysis of Factors Predictive of Complications: A Prospective Study

Introduction: In Morocco, RTUP-m is considered the gold standard for the surgical treatment of prostate adenomas, recommended for prostates with a volume suitable for resection in less than 60 minutes. Additionally, the challenge arises when dealing with patients on antiplatelet or anticoagulant medications due to the associated risk of bleeding, hence the significance of RTUP-b. The objective of our study is to compare the functional outcomes and immediate postoperative complications between these two techniques and to identify predictive factors for complications. Methods: This is a prospective randomized study conducted between January 2022 and September 2022. The variables age, BMI, surgical indication, transrectal prostate volume, ASA classification (American Society of Anesthesiologists), previous pharmacological treatments, IPSS score, quality of life index (QLI), maximum flow rate (Qmax) and postoperative complications were collected. The Chi2 test and Student's t-test were used for statistical analysis. Results: Sixty-nine consecutive patients were included, 38 patients in the monopolar TURP group and 31 in the bipolar TURP group. Both groups were homogeneous in their baseline characteristics. The overall pre-surgical IPSS/QLI/Qmax score was 24,03/4,73/9,47. Functional results at 1st and 3rd month are shown in Table 1. For complications, see Table 2 and 3. These differences were not statistically significant (p = 0,427): the most frequent were hematuria (9,4%) and febrile urinary tract infections (9,4%). Only one patient presented hyponatremia due to glycocol reabsorption in the monopolar group. All complications were Clavien 1 or 2. We found no significant differences between the two groups with regard to complications or their predictive factors. Conclusion: Analysis of our data over the first three months reveals no differences between the two techniques in terms of functional results and postoperative complications, and there are no predictive .........

Outcome of Monopolar versus Bipolar Transurethral Resection of Prostate

Introduction: Transurethral resection of the prostate is the gold standard surgical treatment for benign prostatic hyperplasia with the lower urinary tract symptoms. Bipolar system is a new in technology to lower the adverse effects of monopolar system. This study was designed to find out clinic-demographic data and peri-operative outcomes of the monopolar versus bipolar transurethral resection of prostate. Methods: This prospective comparative study was conducted from June 2022 to March 2023, in the Department of Urology of Bir Hospital, National Academy of Medical Sciences, Nepal. Ethical approval of research was taken from Institutional Review Board, NAMS: Ref No. 735/2079/80. Microsoft Excel was used for descriptive analysis for clinic-demographic and outcome variable data, were presented in frequencies and percentages and their relation were analyzed by chi-square test/fisher’s exact test. A p-value of <0.05 statistically significant. Result: A total 80 patients were compared, bipolar(40 cases) and monopolar(40 cases). There were no differences in the incidence of hyponatremia, clot retention and evacuation rate, re-catheterization rate, mean hemoglobin loss, and mean length of hospital stay. The longer duration of operation time (>60 min) was observed in bipolar transurethral resection ( p=0.001). The transurethral resection syndrome was found only in M-TURP. Conclusion: Both monopolar and bipolar transurethral resection of prostate showed no statistical differences in the amount of resected prostatic tissue, the incidence of hyponatremia, length of hospital stays, blood transfusion rate, re-catheterization rate, clot retention and evacuation rate. The shorter duration of surgery and the trans-urethral resection syndrome was observed in M-TURP.

Two-year follow-up comparing Rezūm therapy versus bipolar transurethral resection of the prostate for treating benign prostatichyperplasia. A prospective randomized study.

Comparison of the efficacy and safety of Rezūm therapy and bipolar transurethral resection of prostate (B-TURP) for the management of benign prostatic hyperplasia (BPH) of 50-120 g size. One hundred patients with BPH who met the inclusion criteria were included and split into two equal groups to undergo Rezūm therapy or B-TURP. The two groups were compared for efficacy using international prostate symptom score (IPSS), quality of life (QoL), maximum urinary flow rate (Qmax), operative time, catheter time, hospital stay, post-void residual urine (PVR), prostate-specific antigen (PSA), and residual prostate size and safety using the incidence of complications. Rezūm significantly ameliorated IPSS from the baseline score by 55.3%, QoL by 50%, Qmax by 62.5%, International Index of Erectile Function (IIEF) by 7.1%, PVR by 50%, residual prostate size by 28.1% and PSA by 42% at 2 years. Meanwhile, the improvement in B-TURP was significantly higher than Rezūm group, Rezūm therapy had a significantly shorter duration of operative time and hospital stay. Also, it had fewer complications in comparison with B-TURP. Rezūm is a minimally invasive procedure that provides significantly improved symptomatic relief of BPH and quality of life with preservation of erectile and ejaculatory functions. However, it is not as effective as B-TURP.

Assessing the Safety and Effectiveness of Bipolar Technology in Transurethral Prostate Resection: A study in a Tertiary Care Private Hospital

Background: Benign enlargement of prostate (BEP) is a common affliction among aging males, predominantly emanating from the transition zone of the prostate, resulting in lower urinary tract symptoms. Despite the availability of diverse treatment modalities, transurethral resection of prostate (TURP) has conventionally served as a benchmark intervention. Recently, there has been a growing interest in bipolar energy techniques, spurred by their potential advantages in mitigating complications such as TUR syndrome and surgical bleeding. Objectives: The main aim of the study to evaluate the safety profile (including serum sodium and hemoglobin reductions, clot retention, TUR syndrome, catheterization duration, and hospital stay) and efficacy (resection rate, maximum flow rate increase, and International Prostate Symptom Score reduction) within the bipolar technique for the TURP. Methods & Materials: A prospective observational study was conducted at the Department of Urology, Square Hospitals Ltd, Dhaka, Bangladesh, spanning December 2020 to November 2021. The study employed comprehensive preoperative assessments, including bipolar transurethral resection of the prostate (B-TURP) using Olympus ESG-400 energy platform. Surgical parameters, postoperative monitoring, and statistical analysis were meticulously executed to evaluate outcomes and complications for symptomatic benign enlargement of prostate. Results: In a sample of 50 individuals undergoing bipolar transurethral resection of the prostate (B-TURP), the distribution of ages revealed 66.97±7.95 years as the bipolar system's average age, ranging from 53-82 years. The majority resided in urban areas (62%), with family income predominantly in the 25000-50000 bracket (42%). Preoperative baseline variables, including IPSS, Qmax, serum hemoglobin, and sodium levels, exhibited similar values between groups. Intraoperatively, the mean resection rate was 0.56±0.16 gm/min. Postoperatively, B-TURP resulted in a slight ......

Results of an Eight Year Long Practice of Saline Bipolar Transurethral Resection of Prostate

Results of an Eight Year Long Practice of Saline Bipolar Transurethral Resection of Prostate

Comparison between bipolar transurethral enucleation versus bipolar transurethral resection of the prostate from 60 to 100 gm: A prospective randomized study

Comparison between bipolar transurethral enucleation versus bipolar transurethral resection of the prostate from 60 to 100 gm: A prospective randomized study

Efficacy of Low Dose Intravenous Epinephrine Infusion in Improving Perioperative Outcomes in Patients Undergoing Transurethral Resection of Prostate: A Prospective Parallel Arm Double-Blind Randomized Control Trial

ObjectiveTo determine the efficacy of intraoperative low-dose intravenous epinephrine infusion in improving intraoperative bleeding and perioperative outcomes of TURP surgery. MethodsThis was a double-blinded, randomized control trial in which all patients undergoing bipolar TURP were included. Patients with uncontrolled hypertension, cardiac disease, and on anticoagulants were excluded. The study group received intravenous epinephrine, whereas the control group received normal saline at the same rate (0.05 μg/kg/min) throughout the procedure. Intraoperative blood loss was the primary outcome. The secondary outcomes were incidence of intraoperative hypotension (due to spinal anesthesia (SA)), resection time, indwelling catheter time, and length of hospitalization (LOH). ResultsThirty-six patients were included in each group. Demographic and clinical profiles were comparable with an overall median prostate size of 41 (34-52) gram in both groups. The primary objective, mean intraoperative blood loss in the study group was lower than the control group but statistically insignificant (67.91+/-18.7 ml vs 75.14+/-17.1 ml; p=0.086). Incidence of intraoperative hypotension was significantly lower in the study group (8.3% vs 33.3%; p= 0.01). Rest of the secondary outcomes, resection time (83 (64-111.5) min vs 86 (68-94.75) min; p=0.97), mean indwelling catheter time (p=0.94), postoperative complications (p=0.73), and LOH (p=0.87) were comparable. ConclusionsIn this first-of-its-kind trial, low-dose epinephrine infusion did not reduce intraoperative blood loss in patients undergoing TURP. However, it significantly reduced intraoperative hypotension, which complicates SA particularly in elderly population.

Challenging the Safety Profile of Bipolar TURP Regarding Dilutional Hyponatremia

Objective: To measure the extent of Dilutional Hyponatremia after Transurethral resection of prostate using Bipolar Resection Technique. Material and Methods: The study was conducted at Social Security Teaching Hospital Lahore. The study was carried out between 1st June 2022 to 30th November 2022. All patients who were candidates of surgical option and were planned TURP were included. They had pre-operative sodium levels done and this was compared to post operative levels on first post operative day. All patients included in the study had moderate prostate size and had resection time less than one hour. Results: Total 45 patients having undergone bipolar TURP were included in the study. Among these 45 patients, 19 patients had a decrease in sodium levels postoperatively ,further in these 19 patients, 14 patients had a decrease of less than 5 mEq/L .In 2 out of total 45 patients the sodium levels remained same post operatively. In 24 patients out of total 45 there was an increase in sodium levels, further in these 24 patients ,19 patients had an increase of less than 5mEq/L . In all 45 patients no clinical symptoms of dilutional hyponatremia were observed. Conclusion: There was no significant dilutional hyponatremia seen after bipolar TURP and wherever observed did not caused any clinical impact , proclaiming Bipolar TURP as a safe option for prevention of dilutional Hyponatremia during surgery for Benign prostate enlargement (BPE).

The effect of tranexamic acid on perioperative blood loss in transurethral resection of the prostate: A double-blind, randomized controlled trial.

Bleeding and bleeding-related complications remain common after bipolar transurethral resection of the prostate (TURP) for benign prostatic hyperplasia. This may possibly lead to prolonged postoperative irrigation, catheterization, and hospital stay. The objective of this trial was to evaluate the effect of high-dose tranexamic acid (TXA) on perioperative blood loss in patients treated with bipolar TURP for prostate sizes between 30 and 80 g. We conducted a single-center, prospective, double-blind, randomized controlled trial. Eighty patients were screened for inclusion between March 2020 and January 2023. After exclusion, 65 patients were randomized in two comparable groups. The TXA group (31 patients) received a TXA intravenous loading dose of 10 mg/kg over 30 min before induction, followed by a maintenance dose of 5 mg/kg/h over 12 h. The placebo group (34 patients) received an equal dose of saline infusion. We measured age, weight, preoperative prostate size, anticoagulant use, 5-alpha reductase inhibitor use, preoperative urinary tract infection, American Society of Anesthesiologists score, difference in pre- and 24 h postoperative hemoglobin and hematocrit levels, operative time, resected adenoma weight, duration of postoperative irrigation, total amount of postoperative irrigation fluid, indwelling catheter time, duration of hospital stay, blood transfusion rate, and 4-week complication rate. Baseline characteristics in both groups were comparable. Postoperative hemoglobin decrease in TXA versus placebo group was 1 versus 1.6 mg/dL, respectively (p = 0.04). In addition, the amount of postoperative irrigation fluid (10.7 vs. 18.5 L), irrigation time (24.3 vs. 37.9 h), catheterization time (40.8 vs. 53.7 h), and hospital stay (46.9 vs. 59.2 h) were statistically significant in favor of TXA use. No blood transfusions were carried out. Four-week complication rate was comparable between the two groups. Perioperative high-dose TXA seems beneficial in reducing hemoglobin loss, postoperative irrigation, catheterization time, and hospital stay in bipolar TURP for prostate sizes between 30 and 80 g, without increased risk of TXA-related thromboembolic events.

A randomized prospective study of the efficacy of ejaculation- preserving bipolar transurethral resection of prostate

A randomized prospective study of the efficacy of ejaculation- preserving bipolar transurethral resection of prostate

Combination of 180-W GreenLight XPS laser and bipolar transurethral resection of prostate for the treatment of large prostates beyond 100ml: a novel hybrid technique.

The aim of this study was to evaluate the safety and efficacy of the 180-W GreenLight laser (GL) XPS™ plus bipolar transurethral resection of the prostate (TURP) for the treatment of a prostate volume (PV) beyond 100ml. From January 2014 to December 2022, 79 patients with PV > 100ml who underwent GL-XPS plus bipolar TURP were enrolled. The median follow-up time was 13.7months. The International Prostate Symptom Score (IPSS), PV, uroflow study, post-void residual (PVR) volume, and prostate-specific antigen (PSA) before and after the operation were recorded. Subgroup analysis was performed to compare the outcomes between the patients with follow-up times of < 36months and > 36months. Statistically significant improvements in all the postoperative parameters were observed in both < 36months and > 36months groups. There was no blood transfusion or transurethral resection (TUR) syndrome in this series. Most of all, a second TURP was unnecessary during the follow-up. Only one (1.3%) Clavien-Dindo grade 3b complication was noted. The hybrid technique of 180-W XPS™ GreenLight laser plus bipolar TURP can be safely and efficiently performed on patients with a prostate volume of > 100ml.

Personalized Approach to the Surgical Treatment of Benign Prostatic Hyperplasia by Bipolar Transurethral Resection of the Prostate

Personalized Approach to the Surgical Treatment of Benign Prostatic Hyperplasia by Bipolar Transurethral Resection of the Prostate

Role Of Prostate Ultrasonography To Predict The Efficacy Of Bipolar Prostatectomy In Benign Prostatic Hyperplasia.

To evaluate the role of prostatic ultrasonography in predicting the clinical outcomes of bipolar transurethral resection of the prostate. The prospective study was conducted at the Urology Department, Kafrelsheikh University Hospital, Cairo, Egypt from December 2018 to June 2019, and comprised male patients complaining of lower urinary tractsymptoms due to benign prostatic hyperplasia. The patients were subjected to pelvi-abdominal and transrectal ultrasonography and values were noted for the international prostate symptom score, uroflowmetry, post-void residual urine volume, ejaculatory domain, and the erectile function domain of the international index of erectile function. The safety of the procedure was assessed using the modified Clavien classification of complications. This was followed by cystourethroscopy under spinal anaesthesia, and then by bipolar resection of the prostate by a single experienced urologist. Operating time, length of hospitalisation, intraoperative and postoperative complications, catheterization time, and changes in haemoglobin levels were recorded. All evaluations were done at baseline and postoperatively at 1, 3 and 6 months. Data was analysed using SPSS 21. There were 109 male patients with mean age 65.53±6.27 years, mean body massindex 24.6±1.7kg/m2 . Mean total prostate volume at baseline was 86.32±43.61gm (range: 30-195m). There was a significant decrease postoperatively (p<0.001). This was associated with a concomitant improvement of international prostate symptoms score, uroflowmetry and post-void residual urine volume over six-month follow-up (p<0.001 ). Overall, 63(57.8%) subjects were sexually active, and there was no significant difference in the international index of erectile function score at baseline and postoperatively (p>0.05). Prostate ultrasonography can be used as a single investigating tool to evaluate the clinical outcomes after bipolar transurethral resection of the prostate.

OUTCOMES ANALYSIS OF TRANSURETHRAL RESECTION OF THE PROSTATE (TURP) AND TRANSURETHRAL VAPORIZATION OF THE PROSTATE (TUVP) IN PATIENT WITH BENIGN PROSTATE HYPERPLASIA: SYSTEMATIC REVIEW

Objective: This systematic review aims to compare IPSS score and Uroflowmetry (Qmax) results between Transurethral Resection of The Prostate (monopolar and bipolar TURP) and Transurethral Vaporization of The Prostate (PVP, ThuVARP, Biolitec, TUEVP, BPV). Material &amp; Methods: Articles were obtained through online searches using Medline, Google Scholar, and Cochrane Library using keywords Transurethral Resection of The Prostate (TURP) dan Transurethral Vaporization of The Prostate (TUVP) and IPSS or Qmax. Results: A total of 6 RCTs and 3 Cohort consisted of 1212 BPH patients treated with TURP (B-TURP and B-TURP) or TUVP (TUVP, BPV, Biolitec, ThuVARP, GLVP(PVP)). There is a significant difference result of IPSS score and Qmax at the third month of follow-up after both therapies. Conclusion: The post-operative IPSS score and Qmax results at the third month of follow-up in BPH patients treated with TURP or TUVP presents varied results. TURP has a better post-operative IPSS score compared to Biolitec Laser, but not superior when compared with TUEVP, BPV, ThuVARP, and PVP. Notably, TURP has better post-operative Qmax results than BPV, TUEVP, and ThuVARP, but not when compared with PVP.&#x0D;

A comparative study between HoLEP and bipolar TURP in the treatment of benign prostatic hyperplasia

&lt;b&gt;Introduction: &lt;/b&gt;Benign Prostatic Hyperplasia (BPH) is one of the most frequent diseases in men. The laser treatment for BPH has challenged TURP due to advances in laser technology, a better understanding of tissue-laser interactions and rowing clinical experience.&lt;br /&gt; &lt;b&gt;Objective: &lt;/b&gt;To evaluate the safety and efficacy of HoLEP, comparing it to Bipolar TURP.&lt;br /&gt; &lt;b&gt;Material and methods: &lt;/b&gt;This was a prospective study to evaluate the outcomes in BPH patients undergoing surgery by HOLEP and Bipolar TURP done between January 2018 to December 2019. A total of 80 Patients were enrolled, 40 undergoing HoLEP and the other 40 Bipolar TURP for BPH. The procedures were performed by a single surgeon. All patients with symptomatic BPH and who were candidates for surgical treatment were included. Patients with previous prostate surgery, urethral surgery, history of prostate cancer or neurogenic bladder were excluded.&lt;br /&gt; &lt;b&gt;Results: &lt;/b&gt;Baseline parameters were almost similar between both the groups in terms of age, IPSS, QOL, Q max, PVR, and gland size. Operative time and resected gland weight were more in HoLEP arm (p&amp;lt;0.001). Catheter time and Hospital stay were significantly low in the HoLEP group (p&amp;lt;0.0001). Hemoglobin drop was not significant (p=0.148). IPSS at three months was similar in both groups (p=0.608). Qmax improved significantly in both groups, with 18.87 ml/s in TURP and 17.87 ml/s in HoLEP with a p-value of 0.261. PVR and QOL were similar between the two groups (P=0.914 and P=0.781).&lt;br /&gt; &lt;b&gt;Conclusion: &lt;/b&gt;Both Bipolar TURP and HoLEP were effective in relieving BOO. HoLEP has equal efficacy compared to conventional bipolar TURP, with decreased hospital stay and catheter indwelling time. The learning curve of HoLEP is steep; however, it can be overcome gradually.