الفهرس 
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Abstract
Benign prostatic hyperplasia is the most common benign neoplasm in men. Bothersome LUTS can occur in up to 50% of men older than 60 years. The degree to which BPH patients are bothered by LUTS varies among individual patient. Treatment options for patients with bothersome moderate to severe symptoms of BPH (I-PSS > 8) include: medical treatment or surgical intervention.
Medical treatment is considered the first line in managing BPH then surgical intervention in cases refractory to medical treatment. There are absolute indications of surgery in BPH like: refractory urinary retention, recurrent UTI, recurrent gross hematuria, bladder stones, renal insufficiency and large bladder diverticula. Other relative indications are: Large residual urine, Moderate to severe LUTS not responding to alpha blockers therapy.
Despite monopolar TURP is being considered for decades as the surgical standard procedure for men with prostate sizes 30-80 gm, it may also associated with some intraoperative complications like: significant bleeding, perforation of the prostatic capsule, perforation of the bladder, injury to the rectum, and development of TUR syndrome resulting from over absorption of hypotonic fluid and its resultant dilutional hyponatremia. Or perioperative Complications like: bleeding, urinary tract infection, and urinary retention. These occur in approximately 7% of patients, sometimes extending the hospital stay by a few days or requiring discharge with an indwelling catheter.
Other newly introduced minimally invasive treatment modalities emerged to avoid the complications of ordinary techniques plasma, Green Light, thulium, and diode lasers vaporization of prostate, Prostatic stents.
Plasma vaporize the prostate gland tissue by creation of an ionized plasma corona, using an axipolar electrode and electro-conductive solutions (normal saline). Also many laser devices were introduced in clinical practice during the past years that was employed in vaporization of prostate. The use of normal saline irrigation (NaCl 0.9%) instead of hypotonic solution to decrease the overall morbidity associated with TURP ,and eliminate risk of TUR syndrome associated with prolonged resection time is the main supposed advantage . Also coagulation of blood vessels gives better hemostatic results.
A newly introduced technology in the field of diode laser is the twister fiber (quartz head contact fiber QH). Which is differ from the standard side firing original fiber that it is end firing fiber with 30 degrees angulation at the distal end, which is covered with Quartz . Laser waves do not emitted from the fiber but gathered in the quartz end producing heat energy.
QLAP (Quartz Laser ablation of prostate) is considered one of the most efficient, fast and safe procedures with less incidence of complications associated with the standard side firing fiber. Also twister fiber gives the surgeon the same tactile sensation of ordinary recectoscopes.
This study aimed at comparing the safety and efficacy of bipolar plasma vaporization in the treatment of patients with prostates less than 80 gm, in comparison to laser vaporization using diode laser 980 nm with quartz headed fiber (QLAP). Our patients were divided into two groups: group I operated by plasma and group II operated by laser, we tried to compare the intraoperative, early postoperative and 6 months follow up results of both groups.
Both techniques whether laser ablation or plasma vaporization are considered safe, effective, minimally invasive procedures in managing prostatic enlargement indicated for surgery. Both techniques are similar in the outcome and both lead to improvement of all parameters of prostatic symptoms. However laser ablation looks to be faster, has stronger power to vaporize more tissues than plasma. No serious complications occurred in both groups. Nevertheless complications are more frequent in the plasma group.