Safety and Efficacy of Bipolar Transurethral Vaporization of the Prostate and Bipolar Transurethral Resection of the Prostate in the Management of Large Volume Benign Prostatic Hyperplasia: A Prospective Randomized Study

PURPOSE: The aim of the study was to compare the functional and sexual outcomes of bipolar transurethral vaporization of the prostate (TUVP) and bipolar transurethral resection of the prostate (TURP) in patients with infravesical obstruction due to BPH. METHODS: This is a randomized controlled study conducted in Urology Department of Beni-Suef University hospital on 72 patients aged above 50 years with infravesical obstruction and indicated for intervention, patients were divided into 2 Groups, Group A 36 patients operated on by bipolar TUVP and Group B 36 patients operated on by bipolar TURP. RESULT: The TUVP group exhibited superior intraoperative and early postoperative outcomes, including shorter operative time (70.28 vs. 87.08 min, p < 0.001), less blood loss (Hb drop 0.37 vs. 1.51 g/dl, p < 0.001), and reduced catheterization/hospital stay (1.19 vs. 2.28 days, p < 0.001) compared to TURP while comparable results in modified Clavien classification of complications. At 1-month follow-up, both procedures showed similar improvements in international prostatic symptom score (IPSS), flow rates (Qmax), and residual urine volume, though retrograde ejaculation was more frequent with TURP (72.2% vs. 41.7%, p < 0.001). By 3-12 months, IPSS and Qmax remained comparable, with no significant differences in erectile function (IIEF). However, TURP showed clinically relevant (though non-significant) advantages in long-term symptom control (IPSS 4.03 vs. 4.92). and urinary flow, suggesting potentially greater durability than TUVP. CONCLUSION: Bipolar TUVP demonstrates notable advantages in early postoperative recovery, including shorter operative times, reduced blood loss, and faster convalescence, positioning it as a minimally invasive alternative for eligible patient. However, TURP may offer superior long-term symptom relief and urinary flow rates despite carrying a higher risk of retrograde ejaculation.