الفهرس 
Anatomy of ProstateOnly 14 pages are availabe for public view
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Abstract
Benign prostatic hyperplasia (BPH), is one of the most common diseases of aging men, it can be associated with bothersome lower urinary tract symptoms (LUTS) that affect quality of life.
The number of patients requiring oral anticoagulation (OA) with coumarin derivatives or platelet-aggregation inhibitors (PAI) is increasing steadily. Currently, approximately 30% of patients admitted for surgery have cardiovascular diseases and are treated with OA therapy. These patients are at increased risk of hemorrhagic complication, and represent therefore a challenging issue for urologist To minimize pre and postoperative bleeding, various minimally invasive alternatives have been introduced, including transurethral laser vaporization and more recently plasma kinetic energy of the prostate. Bipolar transurethral plasma kinetic energy of the prostate is a new technique which could also potentially decrease bleeding Despite the good results and minimal rate of complications associated with laser prostatectomy, the cost of this procedure represent a major obstacle to its use worldwide also the steep learning curve of some of these procedures restrict this technique for a few centers.
Plasma kinetic energy of the prostate combines the low morbidity and the affordable cost which presents the major drawback of laser procedures, especially when it can achieve similar results to TURP in improving the patient’s symptomatology leading to more satisfying International Prostate Symptom Score urinary flow rate and reduction in residual urine volume.
The aim of our work is to evaluate safety and efficacy of bipolar plasma kinetic energy in endoscopic management of BPH and on anticoagulants or platelet aggregation inhibitors.
This study was conducted on 30 patients with symptomatic BPH and on anticoagulants or platelet aggregation inhibitors. The major advantage of this technology is its superior haemostasis which was evident in this study as there was only one patient required blood transfusion post operatively inspite of ongoing on their medications.
The use of saline irrigation eliminate the risk of TUR syndrome, the study showed insignificant change in sodium levels perioperative and none of the patient included experienced TUR syndrome.
Also there was a significant improvement in patients symptomatology,also improvement in IPSS ,uroflowmetry and significant reduction in PVR in follow up visits at 1 mon,3mon and 6 months postoperative.
There was no evidence of any thromboembolic event in all patients.
In addition to the forementioned advantages more rapid catheter removal and a shorter hospital stay and all patients were discharged without catheter and after reintroduction of their anticoagulant medications.
Bipolar plasmakinetic energy is a promising modality for surgical treatment of BPH in patients on anticoagulants.