الفهرس 
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Abstract
More than 50% of men over 50 are affected with Benign Prostatic Hyperplasia (BPH) and more than 35% of them are symptomatic with Lower Urinary Tract Symptoms (LUTS).
Since 1950s, the gold standard surgery for symptomatic cases of benign prostatic hyperplasia (BPH) has been monopolar transurethral resection of the prostate (TURP).
Many minimal invasive technologies have emerged in the last twenty years, diode laser vaporization of prostate or bipolar vaporization of prostate are becoming a new standard.
Bipolar TURP permits treatment while irrigation with isotonic normal saline (NaCl 0.9%) not glycine which provides better visualization and less disturbances in electrolytes preventing TUR syndrome.
Bipolar Transurethral vaporization of the prostate (B-TUVP) has better hemostasis outcome which made it suitable for those who have any bleeding tendency achieving less intraoperative and post operative bleeding which leads to shorter catheterization time and same day discharge.
Laser devices have also conquered the practice of prostate resection specially in high-risk patient that had bleeding tendency or on anticoagulation drugs, in the last few years, the main laser techniques currently used are LBO (lithium Borat), Diode lasers, Holmium yttrium-aluminum-gamete laser (Ho: YAG) and Thulium YAG (Tm-YAG).
All these laser techniques can perform transurethral vaporization or enucleation and can be performed using isotonic normal saline as an irrigation fluid which reduces the risk of TUR syndrome. Also, they have a very good hemostasis profile which made them suitable for patients on anticoagulants treatment.
The primary challenge with diode lasers is deep tissue penetration and coagulative necrosis this is associated with dysuria, passage of sloughed tissue, and higher reoperation rates for bladder neck stenosis.
This study aims to compare two modalities being available for use in Ain Shams University Hospitals, in a prospective randomized fashion: Transurethral prostate vaporization with diode laser and bipolar transurethral vaporization of prostate. The available evidence suggests they provide results comparable to the gold standard method TURP with better outcome in many aspects.
Therefore, this study aimed to compare two techniques in treatment of BPH (Transurethral diode laser prostate vaporization using the Biolitec LEONARDO dual 200 device diode laser and Bipolar transurethral Vaporization of prostate), concerning post operative bleeding, safety, and efficacy (flow rate, hospital stay, time of urethral catheter removal, post-voiding volume by PAUS, IPSS) in patient’s candidate for prostatectomy with bleeding disorders or on anti-coagulant/anti-platelet therapy in a prospective randomized trial.
This Randomized control trial carried out on 52 patients with absolute or relative indication for prostatectomy. All patients were divided into two equal groups:
• group A: patients underwent bipolar transurethral vaporization of prostate.
• group B: patients underwent diode laser vaporization of prostate.
Summary of our results:
• There was no significant difference between both groups as regard age of patients, baseline IPSS, Q max and PVRU (P>0.05).
• IPSS and PVRU was significant lower in 6 months post than Pre among bipolar cases (P<0.001). while Q max was significant higher in 6 months post than Pre among bipolar cases (P<0.001).
• IPSS and PVRU was significant lower in 6 months post than Pre among Diode cases (P<0.001). While Q max was significant higher in 6 months post than Pre among Diode cases (P<0.001).
• IPSS, Q-max and PVRU after 6 months were insignificantly different between studied groups.
• Pre HB was insignificantly different between studied groups(P=0.968), while Post HB was significantly higher in Diode group than Bipolar(P=0.032) with HB DROP being less in diode group than bipolar group (P=0.008)
• Postoperative hematuria (after irrigation stopped) was significantly different between both group (P=0.039).
• Urinary irrigation, hospital stay, and urethral caterer removal were significantly higher in bipolar than diode group.