This prospective randomized study will compare two surgical techniques for treating benign prostatic hyperplasia. Participants will be assigned to either hydrodissection-assisted bipolar prostatic enucleation-enucleoresection with transrectal ultrasound-guided subcapsular injection of diluted norepinephrine and methylene blue or conventional bipolar prostatic enucleation-enucleoresection without injection. The injected mixture is intended to separate the enlarged prostatic tissue from the surgical capsule and reduce bleeding during surgery. The study will evaluate whether the hydrodissection-assisted technique improves operative conditions, surgical outcomes, postoperative recovery, urinary symptoms, and urinary flow compared with the conventional technique.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
100
Transrectal ultrasound-guided subcapsular injection will be used to create a hydrodissection plane between the prostatic adenoma and capsule before bipolar enucleation-enucleoresection.
Participants will undergo conventional bipolar prostatic enucleation-enucleoresection without subcapsular injection or hydrodissection.
Benha University Hospital
Banhā, Qalyubia Governorate, Egypt
Intraoperative Blood Loss
The estimated volume of blood lost during the operative procedure will be recorded in milliliters and compared between the hydrodissection-assisted and conventional groups.
Time frame: Intraoperatively
Operative Time
Operative time will be measured in minutes from insertion of the resectoscope until completion of urethral catheter placement.
Time frame: Intraoperatively
Enucleated Prostatic Tissue Weight
The removed prostatic adenomatous tissue will be weighed in grams.
Time frame: Immediately after tissue retrieval, intraoperatively
Length of Hospital Stay
The duration of hospitalization will be measured in hours from completion of surgery until hospital discharge.
Time frame: From completion of surgery until hospital discharge, assessed up to 7 days
Urethral Catheterization Duration
The duration of postoperative urethral catheterization will be measured in hours from catheter placement at the end of surgery until catheter removal.
Time frame: From completion of surgery until catheter removal, assessed up to 7 days
Change in Maximum Urinary Flow Rate
Maximum urinary flow rate will be measured by uroflowmetry in mL/second. Values obtained after surgery will be compared with the preoperative baseline value.
Time frame: At baseline and at 1, 3, and 6 months after surgery
Change in Post-Void Residual Urine Volume
Post-void residual urine volume will be measured by ultrasonography in milliliters. Values obtained after surgery will be compared with the preoperative baseline value.
Time frame: At baseline and at 1, 3, and 6 months after surgery
Change in International Prostate Symptom Score
Lower urinary tract symptoms will be assessed using the International Prostate Symptom Score, ranging from 0 to 35, with higher scores indicating more severe symptoms. Postoperative scores will be compared with the preoperative baseline score.
Time frame: At baseline and at 1, 3, and 6 months after surgery
Incidence of Postoperative Complications
The proportion of participants experiencing postoperative complications will be recorded.
Time frame: At 1, 3, and 6 months after surgery
Incidence of Intraoperative Complications
The proportion of participants experiencing intraoperative complications will be recorded.
Time frame: Intraoperatively
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