Transurethral Diode Laser Ablation of Prostate Vs Bipolar Transurethral Vaporization of Prostate, A Prospective Randomized Controlled Study

Abstract Background Vaporization/Ablation of prostate is becoming one of the standard modalities for treating of symptomatic cases of lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) especially in men with bleeding tendency. Objective to compare the short term safety and efficacy of bipolar plasma versus laser ablation of prostate and follow up over 6 months post operative. Patients and Methods This prospective randomized control study (double armed) included 60 patients with prostates less than 80 gm operated upon and followed up in the Urology Department of Ain Shams University hospitals. The patients were divided into 2 groups: Group A 30 Patients underwent Transurethral Diode Laser Ablation, Group B 30 Patients underwent Bipolar Transurethral Vaporization as the control group. Results When we compared both groups of patients there was no great difference and both techniques proved great efficiency and safety on patients especially in high risk group of patients, and both of them resulted in improvement in all parameters of LUTS secondary to BPH (decrease of IPSS, increase of Q max, decrease of residual urine and PSA). There was no risk or major complication encountered in the study e.g. no significant bleeding and no risk of TUR syndrome. However operation time was shorter in laser group 22 (mean) min compared to 49 min in bipolar group. Also the mean cost of laser group was about 30000 EGP and the mean cost of bipolar group was 20000 EGP in Ain Shams University hospital. Also catheter time was shorter in laser prostatectomy 24 hours versus 48 hours in bipolar, this is done in trial to lessen the irritative effect of vaporization on the nerve ending, and avoid the expected dysuria. Conclusion Both techniques are considered safe and effective, similar in the outcome and both techniques has excellent hemostatic profile with no serious complications occurred in both groups. Laser is a faster technique than bipolar however it's more expensive.