INITIAL EXPERIENCE WITH PLASMA BIPOLAR TRANSURETHRAL ENUCLEATION AS A TREATMENT OF BPH: A PROSPECTIVE STUDY
Ahmed said El Sabahy, El Sayed M. Hathout, Gamal Ibrahim Selmy
Department of Urology, Faculty of Medicine Al Azhar, university, Cairo, Egypt
Background: Being prostatic hyperplasia (BPH) represents one of the main field of interest of modern urology due to its remarkable high prevalence and negative impact on the patient quality of life.
Objective: The aim of the study is to evaluate the effectiveness and safety of bipolar plasma enucleation of prostate (BPEP) in BPH with adenoma less than 60 gm as regard to surgical efficacy and preoperative morbidity.
Patients and Methods: This is a prospective randomized study was performed in the urology department Al Azhar university hospital and Air force military in Cairo hospital between October 2014 to October 2018 to evaluate the safety and efficacy of BPEP in patients with prostate size adenoma less 60 gm. in 50 patients The primary outcomes were the perioperative morbidity and mortality rates. The secondary outcomes were functional outcomes including maximum urinary flow rate (Qmax), International Prostate Symptoms Score (IPSS), quality of life (QoL) and post-void residual urine volume (PVR).
Results: This study conducted on 50 cases who all fulfilled inclusion and exclusion criteria. The patient age ranged between 52 and 67 years old with mean value of (60.52 ± 3.85) years and adenoma size 45.58 ± 8 gm in an operative time 53.48 ± 5.64 and post-operative irrigation time and catheterization time 1.1 ± 0.2, 2.14 ± 0.57 days respectively. Qmax increased from 4.06 ± 3.35 ml / sec preoperative to19.88 ± 1.36 Ml/sec (p< 0.001) after 12 months postoperative and IPSS decreased from 24.44 ± 4.49 to 7.24 ± 1.27 (p< 0.001) after 12 months. The mean (SD) hemoglobin drop was (0.68%) g/dL, blood transfusion rate was zero. Prostate volume measured by transrectal ultrasonography was significantly reduced from a mean (SD) of 45.58 ± 8 gm preoperatively to 17.54 ± 5.55postoperatively (P < 0.001) no significant complications intra -or postoperatively.
Conclusion: Our data showed that after B-TUEP is visible safe and effective in patients with obstructive BPH.