Login to Access Video or Poster Abstract: MP02-13
Sources of Funding: None.

Introduction

Techniques of Prostatic Adenoma Enucleation by variety of energy sources are commonly practiced for surgical treatment of Obstructive BPH. We compare our short term results of Holmium Laser Enucleation ( HoLEP ) and Bipolar Enucleation ( PKEP/TUEB) in a prospective Randomized trial.

Methods

Between August’15 and April’16, a total of 98 patients with Obtructive BPH were treated and prospectively analysed at our center. A computerized randomization schedule was used. HolEP was done in 52 and Bipolar Enucleation was done in 46 patients. All Patients were evaluated by IPSS, Maximum Flow Rates ( Qmax), Transrectal Ultrasound Guided Prostate Volume(PV), Post Void Residue(PVR) and PSA. 100 W Holmium Laser and Plasmakinetic Bipolar energy by Spatula/Button Electrode was used for enucleation by single surgeon. Primary end points were IPSS and Qmax, secondary being reduction in PVR and PSA. Intraoperative and Immediate postoperative data like OR Time, Blood Loss, Irrigation Volume, Catherization/hospitalization time were compared between two groups.

Results

Pre-operative Demographics in both groups were comparable including Prostate Volume, HolEP ( 58± 8.2gms) versus Bipolar Enucleation _x000D_ ( 56.5±6.8 gms) p value being >0.05. Primary and secondary end points were comparable for both groups (p>.001). Blood loss in HolEP was marginally superior to Bipolar Enucleation ( 36±8.5 ml versus 68.5±7ml respectively, p=0.123). There was no significant difference in other parameters in both groups. OR time (34.5 versus 37 minutes) Catheterisation time ( 2.8 versus 3.1 days), Irrigation Volume (16.9 L versus 17.6 L), Hospital Stay ( 3.4 versus 3.9 days). One patient had prolonged hematuria, without requiring any intervention in bipolar group and two patients in each group had SUI lasting 3-4 weeks. There was no statistically significant difference in Primary and secondary end points in both groups at 1, 3 and 6 month follow-up.

Conclusions

Endoscopic Enucleation is effective irrespective of Energy source. Mean Prostate volume in our study was suggestive of Medium size Obstructive BPH, where, Bipolar Enucleation of Prostate was found to be equally efficacious compared with HoLEP in Short term follow-up. However, long term follow-up results in larger Prostate Volume remains to be seen.

Funding

None.