Vol. 6, Issue 1, Part A (2024)

Background: Recent technological advancements have resulted in the development of enucleation methods for benign prostatic hyperplasia (BPH), which use several laser and plasma techniques. The objective of this study was to evaluate and contrast the effectiveness and safety of bipolar transurethral resection (B-TURP) and bipolar transurethral enucleation (B-TUEP) procedures for prostates ranging in size from 60 to 100 grams.
Methods: This prospective randomized study was carried out on 40 patients with benign prostatic enlargement ranged from 60 to 100 gm and indicated for surgical intervention. This study included unsatisfied patients with the quality of life (QoL) because of the lower urinary tract symptoms (LUTS) despite pharmacological treatments, patients with recurrent urinary tract infection (UTI), refractory urinary retention, recurrent attacks of hematuria or significant post-void residual urine (PVR) above 200 ml. These patients were randomly divided into two equal groups; the odd numbers were for patients in Group A who were candidate for B-TURP, while the even numbers were for patients in Group B who were candidate for B-TUEP. 
Results: In the B-TURP group, the duration of the operation was considerably reduced, and the amount of irrigation fluid used during the surgery was much lower, with a high level of statistical significance (p<0.001). The decrease in hemoglobin levels after surgery was more pronounced in the B-TURP group, and this difference was statistically significant (p<0.001). The duration of catheterization and the length of hospitalization were significantly shorter in the B-TUEP group (p<0.001). There were no significant statistical differences seen between the two groups in terms of the improvement in postoperative IPSS and QOL ratings at 1, 3, and 6 months. The maximum flow rate (Qmax) measured at 3 months after the surgical procedure was considerably higher in the B-TUEP group (P=0.033). 
Conclusions: B-TUEP is an effective procedure with significant improvement in postoperative Qmax and a safe theraputic option of prostatic enlargement between 60 to 100 gm as it was associated with shorter catheterization time and hospital stay with less hemoglobin drop postoperatively. Both B-TURP and B-TUEP had statically significant improvement in IPSS and QoL scores in patients with prostatic enlargement between 60 to 100 gm.