الفهرس 
Surgical Anatomy Of The ProstateOnly 14 pages are availabe for public view
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Abstract
This is randomized prospective study conducted on 60 patients with BPH divided into two equal groups; group I cases of HOLEP and group II cases of standard TURP.
In this study the main age in TURP group was 64.6±663 while in HOLEP group was 66.57±8.41. all patients were subjected to detailed history taking clinical eamination including both general and urological eamination.
Patient evaluation included a complete medical history and physical examination, DRE, urinary tract ultrasound (including measurement of post-void residual urine (PVR) volume), TRUS of the prostate, uroflowmetry (including peak urinary flow (Qmax)) and IPSS.
Laboratory investigation included urine analysis, urine culture if the patient had pyuria, s.cr, CBC & coagulation profile, Na&K level, blood sugar level, liver function test and PSA level.
Urodynamic evaluation if uroflowmetry with special emphasis on Q max. Radiologic investigation includes: abdominal US, TRUS & biopsy and ECHO whenever indicated.
At time of presentation, patients of the TURP group presented with weak flow (53.3%), dysuria (6.7%), hematuria (20%), Frequency (3.3%) and retention (16.7). concerning the thulium group, at time of presentation (56.7%) had a weak flow, (10%) dysuria, (13.3%) presented with hematuria, (10%) with frequency and nocturia and (10%) with retention.
There was no significant statistical difference between the HOLEP and the TURP group at time of presentation concerning the symptom score, hematuria, residual urine and prostate size with p values (0.802), (0.05), (0.759) and (0.858) respectively. Also there was no significant difference between the two groups at time of presentation regarding Qmax, with p values 0.273, Concerning the preoperative laboratory results including renal functions, liver functions, blood picture and serum electrolytes; there was no significant difference between the two groups.
The mean operative time for the HOLEP group was 91.51±34.012 minutes. While the mean operative time for the TURP group was 72.833±10.36 minutes. The mea catheterization time for the HOLEP group was 1.07±0.254 days. While the mean catheterization time for the TURP group was 3.83± 0.913 days. The type of fluid used in the HOLEP was saline in all patients and average amount used was 52.5 liters. While the type of fluid used in the TURP was distilled water in all patients and the average amount used was 41.5 liters.
The hospital stay was 1.37 ± 0.490 day in the HOLEP group while the hospital stay was 4.73± 0.980 days in the TURP patients. The mean serum hemoglobin in the HOLEP group was 10.940± 1.38 gm/dl. The mean serum hemoglobin loss per patient was 0.95 ± 0.82 gm/dl. The mean serum hemoglobin in the TURP group was 10.06± 1.085 gm/dl. The mean serum hemoglobin loss per patient was 1.914 ±0.74 gm/dl. There was a statistically significant difference between the two groups regarding; catheterization time and hospital stay in favor of HOLEP group with p value 0.001 and 0.001 respectively. There was also significant statistical difference between the two groups regarding operative time with p value 0.044 in favour TURP.
Blood transfusion was needed in two patients (6.7%) in the HOLEP but in 6 patients (20%) of the TURP group. There was no significant statistical difference between the two groups regarding blood transfusion with p value 0.129.
No TUR syndrome was developed in the HOLEP group. While only two patients (6.7%) developed TUR syndrome in the TURP group. None of our patients in both groups developed injury to the bladder wall or ureteric orifices during the operation. All patients succeeded to void after catheter removal.
There was combined urge and stress incontinence in twelve patients (40%) in the HOLEP group within the first week. While there was only six patients (20%) in the TURP group who complained of urge and stress incontinence. Its p value 0.06 and this result not statically significant at p value less than 0.05.
There was no significant difference between the two groups in the results of the maximum urinary flow rate, PVR and IPSS with p values 0.135 , 0.442 and 0.127 respectivly.