Comparative Study between Transurethral Enucleation of the Prostate Using Plasma Vaporization and Transurethral Bipolar Resection of the Prostate

Abstract

Background: Benign prostatic hyperplasia (BPH), also called benign enlargement of the prostate (BEP or BPE), is a non-cancerous increase in size of the prostate. It involves hyperplasia of prostatic stromal and epithelial cells. BPH is a common problem among the aging men. It is reported that BPH occurs in 15% to 60% of men aged more than 40 years, and its prevalence increases markedly with age. Aim of the Work: To compare between transurethral enucleation of the prostate using plasma vaporization and bipolar transurethral resection regarding to efficacy, operative time, post-operative bleeding, hospital stay, catheterization duration and early complications. Patients and Methods: Type of Study: Prospective. Study Setting: data was being collected at Ahmed Maher Teaching Hospital and Cairo Specialized Hospital. Study Period: 6 months. Patients aged between 50-75 years old with prostatic size ranging between 40-120 gm and Complicated BPH with refractory retention, recurrent attacks of hematuria, recurrent urinary tract infection (UTI) or Failed medical treatment with alpha blockers, International prostate symptom score (I-PSS) questionnaire is 18 or more and Q max is less than 15 ml/ sec. Sample Size: 20 patients divided into two groups: Group A; (10 cases underwent for transurethral enucleation of the prostate using plasma vaporization, Group B; 10 cases underwent for transurethral bipolar resection of the prostate). Results: In our study, we reported that 1 patient in group A (1/10) in PKEP arm required post-operative blood transfusion while 2 patients (2/10) required transfusion in TURIS. Other study demonstrated that there was a transfusion rate of 1.4% in favor PKEP group versus 8.6% in open prostatectomy group. In our study, we found that the reported mean catheter time in group A was 32.40 hours and hospital stay time was 43.20 hours. Conclusion: Vapoenucleation of the prostate and Bipolar TURP using saline irrigation system are technologic innovation based on an idea that has been present for some years. This study showed very good result of vapoenucleation group as an alternative to bipolar TURP, efficacy, with shorter catheterization and hospitalization time. Likewise, with improved vision during surgery, surgeons can achieve superior hemostasis and it's suggested especially in a highly selected group of patients at high risk. Vapoenucleation provides a new option among minimally invasive surgical treatments for BPH. The short- term complication profile appears to be better than with bipolar TURP, but further studies are required to prove this because there is certain variability in the rate of occurrence of some of them. Keywords: Transurethral Enucleation, Prostate, Plasma Vaporization, Transurethral