To compare safety and efficacy of bipolar plasmakinetic enucleation (BPEP) versus holmium laser enucleation (HoLEP) for management of large BPH (>80gm).
Patients with failed medical treatment, International Prostate Symptom Score (IPSS)>13, peak urinary flow rate (Qmax)<15ml/sec and prostate size ≥80gm were enrolled in this randomised controlled trial from from November 2016 to February 2018 and managed by HoLEP (Group A; 33patients) or BPEP (Group B; 31patients). Patients on anticoagulants were not excluded. Patients were followed-up for 12 months. Perioperative data was compared between both groups using Student-t, Mann-Whitney, Paired-t, Wilcoxon signed rank, Chi-Square, or Fisher-Exact tests as appropriate.
There was no significant difference between both groups in age, rate of presentation with urinary retention, recurrent hematuria, frequency of patients on anticoagulants/antiplatelets, prostate size, PSA, Qmax, IPSS, quality of life (QoL) and post-void residual urine (PVRU). Operative time was significantly longer in BPEP (p=0.003) as well as catheterization duration (p=0.019). Other perioperative parameters including level of Na+ and hemoglobin, resected tissue weight, hospital stay and complications were not significantly different between both groups. There was no need for blood transfusion in all patients. There was significant postoperative improvement in IPSS, PVRU, QoL, PSA and Qmax in each group. However, there was no significant difference between both groups in these parameters.
HoLEP and BPEP are comparable regarding safety and efficacy for treatment of BPH (>80gm) including patients on anticoagulants. However, BPEP required a longer catheterization duration and operative time.
Journal of endourology. 2019 Dec 06 [Epub ahead of print]
Enmar Habib, Loay M Ayman, Mohammed Said ElSheemy, Ahmed S El-Feel, Amr Elkhouly, Hany H Nour, Mohamed H Badawy, Ahmad G Elbaz, Mamdouh A Roshdy
Cairo University Kasr Alainy Faculty of Medicine, 63527, Urology, Cairo, Egypt; ., Theodor Bilharz Research Institute, 230796, Urology, Giza, Giza, Egypt; ., Cairo University Kasr Alainy Faculty of Medicine, 63527, Urology, Cairo, Egypt; ., Cairo University Kasr Alainy Faculty of Medicine, 63527, Urology, Cairo, Egypt; ., Theodor Bilharz Research Institute, 230796, Urology, Giza, Giza, Egypt; ., Theodor Bilharz Research Institute, 230796, Urology, Giza, Giza, Egypt; ., Theodor Bilharz Research Institute, 230796, Urology, Giza, Giza, Egypt; ., Theodor Bilharz Research Institute, 230796, Urology, Giza, Giza, Egypt; ., Theodor Bilharz Research Institute, 230796, Urology, Giza, Giza, Egypt; .