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Sources of Funding: none

Introduction

: Bipolar TURP by resection loop and vaporization button are commonly used nowadays for treatment of BPH because it causes less intraoperative bleeding, and avoids free water absorption. However, bipolar vaporization may be associated with increased operative time and postoperative morbidity. By adding resection we can minimize operative time and clean prostatic fossa from prostatic tissue shreds making prostatic fossa more smooth and regular. We compare results of combined Bipolar TURP using the resection loop and vaporization versus vaporization alone for BPH to determine the relative safety and efficacy of both technique.

Methods

77 patients with BPH were included in this study and randomized to operation either by Olympus (Gyrus) Bipolar loop TURP and Olympus (Gyrus) Bipolar button vaporization (Group 1) 40 patients or Olympus (Gyrus) Bipolar button vaporization alone( Group 2) 37 patients . Inclusion criteria were; BPH with qmax <10ml/sec, IPSS score>18 and prostate volume >40 gm. All patients were evaluated preoperatively and at 1, 3 and 9 months postoperatively by IPSS, uroflowmetry and prostate ultrasound. Clavien complications and operative time were recorded._x000D_ _x000D_

Results

This study included 40 patients in Group1 (combined Bipolar Vaporization And Resection) and 37 patients in Group 2. (Bipolar Vaporization alone).There was no significant difference as regard age ( 51 + 9.9 and 52.5 + 8.2) , hospital stay (1-2 days) or catheterization period (1-2 days) in both groups. Preoperative prostate volume (58 g v 55 g p=0.51) and IPSS (20 v 22 p=0.38) was equivalent. Significant increase in operative time was noticed in Group 2 (79± 15 minutes range 45-105 p <0.001) , versus (mean 59 ± 10 minutes range 35-75 minutes ,smale non-significant difference in blood loss occurred in both Groups (0.8% compared to 0.9% drop in hemoglobin, p<0.55) but increased postoperative urinary frequency (75% in G2 vs 45% in G1 ( p <0.001), hematuria with clots as long as 3 weeks after surgery (18% vs 2%, p <0.001s p=0.22), :) and postoperative urethral stricture (4% vs 0%). There was No significant difference in Q max improvement Qmax (20 cc/s vs 18 cc/ s ) or postoperative prostate volume (32 vs 31 g p=0.31) and IPSS (6 v 5 p=0.22) equivalently

Conclusions

Combined Bipolar vaporization and resection of the prostate, is superior to Bipolar Vaporization alone as regard operative time and postoperative morbidity without compromising its efficacy and safety.

Funding

none