الفهرس 
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Abstract
Benign prostatic hyperplasia (BPH) is a frequent disease in ageing men associated with bladder outlet obstruction (BOO). The basic principles of BPH endoscopic treatment have gathered around three main transurethral surgery concepts: resection, vaporization, and enucleation. from a particular perspective of BPH pathology, it was observed that, while a variety of therapeutic solutions and technical innovations focused on bringing improvements to BOO endoscopic treatment, large size BPH cases (>80 ml) continue to have open prostatectomy (open prostatectomy) as the first-line alternative.
However, the conventional M-TUE was associated with a substantial morbidity rate imposing the search for more minimally invasive alternatives. During the past decade, many new minimally invasive techniques, such as transurethral microwave thermotherapy, transurethral needle ablation, bipolar transurethral resection in saline (TURis), or LASER procedures, have emerged. Despite proven efficacy, LASER techniques, either holmium, Greenlight or Thulium LASER have not yet become widely used because of the perceived steep learning curve and the costs associated with high power LASER systems.
A bipolar plasma kinetic vaporisation system with a novel mushroom-like electrode was developed. As an
alternative technique, the TURis plasma vaporisation was described as a safe and effective treatment option for patients with lower urinary tract symptoms (LUTS) from BOO. In this study, a hybrid technique that combines two techniques using the same cutting current and technological setup proposed enucleation of the prostate gland and resection with a TURis cutting loop compared to the standard open prostatectomy. This technique is defined as transurethral vapour enucleation and resection of the prostate (TBERP).
This is a Comparative, Prospective Study done at Helwan and Misr University for Science and Technology Hospitals on men aged over 50 years who visited a urology outpatient clinic within 24 months.
Thirty patients were treated by B-TUE. The other Thirty- cases were treated by M-TUE. Patients were evaluated preoperatively and at 1-week post catheter removal and 1-3-months postoperatively in terms of blood loss, operation time, the weight of resected prostatic tissues, post- operative catheterization period, hospital stay, IPSS, PVR, prostate volume, early complications (recatheterization, urine retention, UTI and irritative symptoms) and late complications (urinary incontinence, urethral stricture and bladder neck contracture).
The relation between the two groups shows no statistically significant difference regarding all the preoperative
parameters, which is good randomization. As far as the actual surgical efficiency was concerned, there was no statistically significant difference in the mean operation duration, and resected tissue weight data gathered. The TBERP produced a substantially decreased surgically induced bleeding during the intraoperative period.
Moreover, the B-TUE patients benefited from a shorter postoperative recovery, a significantly lower mean catheterization period and hospital stay. from the point of view of surgery-related patient comfort and functional outcomes, similar symptom scores and voiding parameters were established after B-TUE and M-TUE.
Regarding short-term complications, the B-TUE rate of recatheterization for acute urinary retention or blood clots evacuation was decreased compared with transvesical prostatectomy. Also, the rates of early irritative symptoms and urinary tract infections were statistically similar in the respective study arms, with a slightly higher rate of irritative symptoms in the B-TUE group. Regarding the long-term complication follow-up, the data revealed that there is no significant difference between the two groups concerning bladder neck contracture, urethral strictures, and urinary incontinence.
In conclusion, B-TUE can be performed safely and is an equally effective endourologic procedure for treating large BPH with M-TUE. The B-TUE is associated with fewer complications and quick postoperative recovery while reducing the morbidity than M-TUE.