Bipolar Enucleation of the Prostate Versus Bipolar TURP

Ain Shams University120 enrolled

Overview

Bipolar enucleation of the prostate (BEEP) was introduced to treat patients with large prostate. The study compared the functional outcomes and perioperative complications of bipolar TURP and bipolar enucleation of large prostates above 80 gm.

Recent literature suggests that enucleation techniques may provide superior functional results, reduced bleeding, and lower retreatment rates. Nevertheless, there remains limited high-quality randomized controlled data directly comparing bipolar TURP and bipolar enucleation of prostate as a head to head comparison regarding functional outcomes and peri-operative complications. In this study, a randomized controlled trial was performed to compare bipolar enucleation of the prostate versus bipolar transurethral resection of the prostate in BPH regarding symptoms relief, residual adenoma, urine flow rate and post-operative morbidity.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

120

Conditions

Benign Prostate Hypertrophy(BPH)

Interventions

bTURPPROCEDURE

transurethral resection of the prostate by bipolar current

BEEPPROCEDURE

endoscopic enucleation of the prostate by bipolar current

Eligibility

Sex: MALEMin age: 40 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: * All male patients above the age of 40 years who presented to the urology clinic in Ain Shams university hospitals with BPH with prostate size 80 - 120 g and have any of the following criteria: * Voiding symptoms that are poorly responsive to medical treatment (IPSS more than 18 and Qmax less than 15 ml/sec) * Persistent or recurrent attacks of urine retention due to BPH. * Large bladder stones from BPH. * Recurrent UTI due to BPH. * Severe gross hematuria from BPH. Exclusion Criteria: * Patients with untreated or active UTI. * Previous pelvic radiation or pelvicl trauma. * Patients with anesthesia contraindications such as uncontrolled diabetes mellitus, severe coagulation disorders and severe cardiac diseases. * Known or suspected neurogenic bladder. * Urethral stricture or urethral cancer.

Locations (1)

Ain Shams university hospitals

Cairo, Cairo Governorate, Egypt

Outcomes

Primary Outcomes

volume of residual prostatic adenoma

measurement of volume of residual prostatic adenoma post bipolar TURP and BEEP was done by pelvi-abdominal ultrasound

Time frame: one month postoperative

change in international prostate symptoms score

The international prostate symptoms score is a patient-completed questionnaire for standardized assessment of lower urinary tract symptoms (LUTS). It includes seven questions that evaluate the following urinary symptoms: * Weak urinary stream (0 : 5) * Incomplete bladder emptying (0 : 5) * Straining during urination (0 : 5) * Intermittent urine flow (0 : 5) * Increased urinary frequency (0 : 5) * Urgency (0 : 5) * Nocturia (0 : 5) Grade 1 (score = 0 - 7) : Mild LUTS Grade 2 (score = 8 - 19) : Moderate LUTS Grade 3 (score = 20 - 35) : Severe LUTS

Time frame: pre-operative, one, three, six and twelve months postoperative

change in maximum urine flow rate(Q max)

Maximum urine flow rate was evaluated by Uroflowmetry

Time frame: pre-operative, 1, 3, 6 and 12 months postoperative

Secondary Outcomes

change in post voiding residual urine

post voiding residual urine in bladder was evaluated by Trans-abdominal ultrasound

Time frame: pre-operative, 1, 3, 6 and 12 months postoperative

operation time

Operation time was calculated from insertion of the cystoscope/resectoscope into the urethra to final removal of the scope

Time frame: during operation

Data from ClinicalTrials.gov

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