title: Comparative randomized study on the efficaciousness of treatment of BOO due to BPH in patients with prostate up to 100 gr by endoscopic gyrus prostate resection versus open prostatectomy. Preliminary data.
abstract: OBJECTIVE
  With the advent of medical management and minimally techniques for benign prostate hypeplasia (BPH), invasive surgical procedures such open prostatectomy (OPSU) have become less common, although selected patients may still benefit from open prostatectomy. Aim of this study was to evaluate efficacy and safety of Bipolar TURP (Gyrus electro surgical system) versus standard open prostatectomy in patients with lower urinary tract symptoms (LUTS) due to bladder outlet obstruction (BOO) with markedly enlarged glands refractory to medical therapy.
  
  
  METHODS
  From January 2003 to January 2004, 140 patients affected by mild-severe LUTS, secondary to BOO from BPH, refractory to medical therapy, with markedly enlarged glands, were randomized in two groups (1:1), and subjected to open prostatectomy (OPSU) carried out with traditional method (Bracci Thechnique) versus transurethral resection of the prostate (TURP) utilizing the bipolar methodology. Preoperative work-up included IPSS, IIEF-5 and Qol questionnaires. All patients were submitted to uroflowmetry, transrectal ultrasound (TRUS), measurament of postvoidal residual urine and PSA determination. IPSS, IIEF-5 and Qol, uroflowmetry, TRUS, measurement of post-voidal residual urine, PSA determination and number of reoperations were evaluated at 1, 3, 6, 12, 18, 24, 30 and 36 months. Operative time, resected tissue weight and perioperative complications were also registered. Total post-operative catheter time, total postoperative hospital stay, haemoglobin loss were recorded in the 2 groups.
  
  
  RESULTS
  Comparative data on IPSS symptom score, IIEF-5 and Qol, PSA, peak urinary flow rates and post-void residual urine volume in the 2 groups were similar but showed a significative improvement with respect to baseline value. Postoperative haemoglobin levels, postoperative catheterization, hospital stay and 3-yr overall surgical re-treatment-free rate were significantly better in the Bipolar group.
  
  
  CONCLUSIONS
  In the treatment of LUTS due to bladder outlet obstruction (BOO) with markedly enlarged glands refractory to medical therapy, Bipolar TURP has a comparable outcome to open prostatectomy at short and medium term according to both subjective and objective outcome measures.
authors.affiliation: Division of Urology, Villa Tiberia Clinic, Rome, Italy. roberto.giulianelli@virgilio.it
authors.forename: Roberto
authors.initials: R
authors.lastname: Giulianelli
authors.forename: Stefano
authors.initials: S
authors.lastname: Brunori
authors.forename: Barbara Cristina
authors.initials: BC
authors.lastname: Gentile
authors.forename: Giorgio
authors.initials: G
authors.lastname: Vincenti
authors.forename: Stefano
authors.initials: S
authors.lastname: Nardoni
authors.forename: Francesco
authors.initials: F
authors.lastname: Pisanti
authors.forename: Teuta
authors.initials: T
authors.lastname: Shestani
authors.forename: Luca
authors.initials: L
authors.lastname: Mavilla
authors.forename: Luca
authors.initials: L
authors.lastname: Albanesi
authors.forename: Francesco
authors.initials: F
authors.lastname: Attisani
authors.forename: Gabriella
authors.initials: G
authors.lastname: Mirabile
authors.forename: Manlio
authors.initials: M
authors.lastname: Schettini
mesh_terms: D000368:Aged; D004598:Electrosurgery; D006801:Humans; D008297:Male; D009929:Organ Size; D011467:Prostate / Q000473:pathology; D011468:Prostatectomy / Q000379:methods*; D011470:Prostatic Hyperplasia / Q000150:complications / Q000473:pathology / Q000601:surgery*; D053448:Prostatism / Q000209:etiology / Q000601:surgery*; D020728:Transurethral Resection of Prostate / Q000379:methods; D001748:Urinary Bladder Neck Obstruction / Q000209:etiology / Q000601:surgery*