الفهرس 
Material and methodsOnly 14 pages are availabe for public view
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Abstract
This prospective study was designed to evaluate the efficacy,safety and outcome of Rotoresection as a modality for prostatic ablation in comparison to the gold standard surgical
procedure: TURP. The study comprised 60 patients with BPH presented to
urology outpatient clinic of Benha university hospital from january
2003 to february 2004 with lower urinary tract symptoms, randomly
divided into two groups (RRP and TURP) according to the
procedure assigned with a non-significant difference as regards
the age and preoperative I-PSS, quality of life index, prostatic
volume and voiding cytometric parameters.
The mean resection time in TURP group was 47±5.6 min,
while in RRP group was 32.8±12.9 min, there was a significant
(P<0.05) shortening of the resection time in RRP group in
comparison to resection time in TURP group.
The mean irrigate volume used during TURP was 11.2±2.7
liter, while in RRP the mean irrigate volume used was 9.3±2.8 liter.
There was a significant (P<0.05) increase in the irrigate volume
used during TURP in comparison to volume used during RRP.
The duration of postoperative catheterization was 2.3±0.9
days in patients underwent TURP. while was 1.6±0.6 days in
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patients underwent RRP with a significant (P<O.05) prolongation of
the duration of PO catheterization in TURP group.
Patients included in both groups showed a significant
decrease of hemoglobin concentration in comparison to their
preoperative measures, however, the decrease is also significant
in patients underwent TURP in comparison to those underwent
RRP.
Urine analysis and culture were performed one month postoperative
for all the study participants. In 8 patients, 3 in RRP and
5 in TURP groups, pyuria was detected on microscopic
examination (pus> 5/HPF).
Preoperative I-PSS and quality of life index of patients
included in both groups showed a non-significant (P>O.05)
difference, while showed progressive significant (P<O.05) decrease
in both groups throughout the follow-up period in comparison to
the preceding score in the same group and to the preoperative
ones with a non-significant difference between both groups.
Furthermore,the mean preoperative Q-max was 8.3±2.3; and
7.9±2.5 in patients underwent TURP and RRP; respectively, 6-
months after surgery,the mean Q-max became 24.8±10 in TURP
group and 25.7±8.8 in RRP group with a significant (P<O.05)
increase in postoperative measures in comparison to their
preoperative measures In addition,the mean PVR volume was
significantly (P<O.05) decreased 6-months postoperatively in both
groups.
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Three patients in RRP group, two developed hematuria on
the 7th and 10th days after discharge and the third had urine
retention two days after catheter removal. Both were managed
conservatively by urethral catheter fixation for 3 days, antibiotics,
anti-inflammatory, drugs and hemostatics, After catheter removal
all voided spontaneously with Qmax 24, 22 and 20 ml/sec,
respectively.
Three patients; 2 in TURP group (6.6%) and one in RRP
group (3.3%) had mild degree of stress incontinence, both were
managed conservatively.
Four patients; 3 in TURP group (10%) and only one in RRP
group (3.3%), developed bladder neck contracture, 6 months
postoperatively and all were managed by BNI.
Out of the obtained results, it could be concluded that
Rotoresection as an endoscopic modality for prostatic ablation in
cases of PBH is effective with shorter duration of surgery,
decreased amount of irrigate, decreased intra and postoperative
bleeding and provided acceptable range of postoperative
complications. It is a safe procedure with better preservation of patient hemodynamic parameters and shorter hospitalization period and could achieve patient’s satisfaction.