Prospective Randomized Study Comparing the Intra-Operative and Postoperative Outcomes of Bipolar Enucleation of the Prostate Versus Thulium Laser Enucleation

Abstract

Background: Benign prostatic hyperplasia (BPH) is an age-dependent patho-physiological condition. Bipolar enucleation of prostate (BipolEP) is now considered a rather effective method for the management of BPH patients. Aim and objectives: to assess the functional outcome of patients post plasma-kinetic enucleation in patients with large size prostate glands more than 80 cc as measured by Trans-rectal ultrasound. Patient and method: Our study involved 40 patients with symptomatic BPH who underwent endoscopic enucleation of the prostate using bipolar energy. Result: As regard the intraoperative complications our study showed that there were two patients (6.7%) complicated by small bladder perforation during morcellation and four patients (13.3%) had intra-operative bleeding necessitating blood transfusion and in the early postoperative period (the first 48 hours); one patient (3.33%) developed postoperative hematuria. After one month follow up we found that: 12 patients (30%) developed urge incontinence, 7 patients (17.5%) developed stress urinary incontinence and 5 patients (12.5%) developed mixed incontinence one with predominant urge and the other with predominant stress Conclusion: Bipolar enucleation (BipoLEP) is very effective for managing patients with symptomatic or complicated BPH with large gland size above 80 cc, having a high safety profile and low complications rate. Bipolar enucleation proved to be a very effective technique of endoscopic enucleation of the prostate and can stand out as a strong alternative to laser enucleation whenever laser facilities are not available with comparable results.