Comparative Study between Bipolar Transurethral Resection and Bipolar Transurethral Enucleation of the Prostate for Managing Benign Prostatic Hyperplasia

Abstract

Introduction: Benign prostatic hyperplasia is considered a common disorder that occurs with advancing age in
males. The bladder outlet obstruction is the main complaint associated with this condition that could be managed
with different endoscopic approaches the traditional one is the transurethral prostatic resection and recently the
transurethral prostatic enucleation has emerged. This study aimed to compare between both techniques.
Methods: This was a clinical trial performed at Ahmed Maher Teaching hospital. Patients were randomized to
either Group (1): (TUEP) patients subjected to the bipolar transurethral enucleation of prostate and Group (2):
(TURP) patients subjected to the bipolar transurethral resection of the prostate. After the surgical procedures,
the patients were compared regarding the success rate and the perioperative complications. Three months after
surgery, assessment was done through uroflowmetry studies, post-voiding residual volume of urine and the
International Prostate Symptom Score.
Results: The mean duration of the procedure showed no significant differences between both groups in TUEP
(82.8±8.4 min) vs (79.7±8.80 min) TURP (P=0.262). Post-operative drop of haemoglobin level was less in TUEP
vs TURP (0.79±.14 vs 1.41±.42) g/dl (P=0.007), in addition to shorter time needed for catheters (46.10±10.18 vs
56.65±13.14 hr; P=0.036) and less duration of hospital stay (53.70±9.13 vs 62.40±12.06 hr; P=0.001). A significant
improvement was observed between baseline and 3 months postoperatively regarding uroflowmetry (Qmax),
IPSS and PVR in both groups.
Conclusion: The mean operative time was nearly similar in both groups, however TUEP was associated with less
bleeding, shorter time needed for catheters, less time needed for hospital stay. After 3 month, uroflowmetry Qmax,
PVR and IPSS were similar in both procedures.