Standard Transurethral Resection Research Articles

Comparison of photoselective vaporization and standard transurethral resection of the prostate on urodynamics in patients with benign prostatic hyperplasia

To compare photoselective vaporization of the prostate (PVP) and transurethral resection of the prostate (TURP) in patients with benign prostatic hyperplasia. Patients were enrolled in a prospective non-randomized trial and underwent PVP (n = 78) and TURP (n = 51). Primary outcome variables included: International Prostate Symptom Score, quality-of-life score, urinary peak flow and post-void residual urine volume at 3, 6 and 12 months postoperatively. Secondary outcomes were urodynamic variables, including the index of bladder outlet obstruction (BOO) and detrusor contractility. Improvement in all outcome variables after PVP was comparable to that after TURP within 12 months. Outcome based on urodynamic parameters was also similar. Pre/post median value of the BOO index was 63/2 in the PVP group and 61/5 in the TURP group. Pre/post rate of detrusor overactivity was 49%/27% in the PVP and 53%/29% in the TURP group. There was minimal change in detrusor contractility. Overall, morbidity was comparable in the two groups. The 12-month outcome after PVP is similar to that of TURP with an effective relief from BOO and detrusor overactivity and minimal change in detrusor contractility.

The clinical observation of bipolar transurethral plasma kinetic resection of prostate for high risk benign prostate hyperplasia

To evaluate therapeutic effect and reliability of bipolar transurethral plasma kinetic prostatectomy (TUPKP) for high risk level benign prostatic hyperplasia (BPH). A total of 230 cases of high risk of BPH were treated with TUPKP. Among them, 132 cases with the residual urine of 40 to 420 ml had accepted long term but inefficient medical therapy, 98 cases were suffered with repeating acute urinary retention. One hundred and seventy-three cases with the functional capacity>4 MET were performed the standard transurethral resection of the prostate (TURP), the other 57 cases with the functional capacity<4 MET were accepted the minimally invasive TURP. Among them 12 cases complicated with bladder stones accepted Ho: YAG lithotripsy priory. The international prostate symptom score (IPSS), The maximal urinary flow rate (Qmax) and residual urine of the 2 groups before and after operation were analyzed. There was no transurethral resection syndrome occurred in both groups. After 3 to 12 months of follow-up postoperatively, the IPSS of the two groups were reduced from (21.9+/-5.7) and (23.7+/-5.0) to (4.4+/-2.3) and (5.5+/-2.4), residual urine were reduced from (61.8+/-18.4) ml and (103.9+/-77.3) ml to (13.0+/-6.2) ml and (15.8+/-6.1) ml, respectively. The Qmax was increased from (5.7+/-3.0) ml/s and (4.8+/-2.8) ml/s to (20.9+/-6.3) ml/s and (16.8+/-3.9) ml/s, there existed significant differences (P<0.01). However the IPSS, Qmax and residual urine of the standard group had progressed more obviously than the minimally invasive TURP group (P<0.05). It is safe and effective to use TUPKP for treating high risk patients of BPH with classic TURP and minimally invasive TURP according to different functional capacity. When the functional capacity is more than 4 MET, the standard procedures is preferred.

Maintenance of Erectile Function after Photoselective Vaporization of the Prostate for Obstructive Benign Prostatic Hyperplasia

Photoselective vaporization of the prostate (PVP) with the greenlight laser has become a popular alternative to the standard transurethral resection of the prostate for patients with benign prostatic hyperplasia (BPH). Our initial results of postoperative erectile function are presented. To prospectively evaluate the postoperative erectile function of the first 105 consecutive patients undergoing PVP at Texas A&M Health Sciences Center, Scott & White Memorial Hospital, using the Sexual Health Inventory for Men (SHIM) questionnaire. Institutional Review Board approved this case series of 105 consecutive patients who underwent PVP. The men were divided into three groups depending on their preoperative bladder management: Group N-catheter free (N = 86), Group Y-indwelling catheters (N = 8), and Group clean intermittent catheterization (CIC)-performing clean intermittent catheterization (N = 11). SHIM scores were obtained and compared preoperatively and at 12-month follow-up visit. The mean age of the 86 patients in group N, who did not require an indwelling catheter or CIC preoperatively, was 71.8 years. Their mean preoperative SHIM score was 10.7, and was 10.4 postoperatively. The mean age of the eight patients who were in group Y, who did require an indwelling catheter preoperatively, was 76.8. Their mean preoperative SHIM score was 10.5, and improved to 23 postoperatively. The mean age of the 11 patients in group CIC, who performed CIC preoperatively, was 71.8 years. Their mean preoperative SHIM score was 6.0, and was 5.8 postoperatively. Sexual function was maintained by patients who underwent PVP for obstructive BPH and who were catheter free or required CIC preoperatively, and was improved for men who had indwelling catheters preoperatively. There was no statistically significant difference between preoperative and postoperative sexual function after PVP for men with either mild or no erectile dysfunction preoperatively.

A safe and simple solution for intravesical tension‐free vaginal tape erosion: removal by standard transurethral resection

To report our experience with the successful removal of visible tension-free vaginal tape (TVT) by standard transurethral electroresection, as intravesical tape erosion after TVT is a rare complication, and removal can be challenging, with few cases reported. Five patients presenting with TVT erosion into the bladder were treated at our institutions from December 2004 to July 2007; all had standard transurethral electroresection. Their records were reviewed retrospectively to retrieve data on presenting symptoms, diagnostic tests, surgical procedures and outcomes. The median (range) interval between the TVT procedure and the onset of symptoms was 17 (1-32) months. The predominant symptoms were painful micturition, recurrent urinary tract infection (UTI), urgency and urge incontinence. There were no complications during surgery. The storage symptoms and UTI resolved completely after removing the eroded mesh in all but one patient. Cystoscopy at 1 month after surgery showed complete healing of the bladder mucosa. Although TVT erosion into the bladder is rare, persistent symptoms, particularly recurrent UTIs, must raise some suspicion for this condition. Standard transurethral electroresection seems to be a safe, simple, minimally invasive and successful treatment option for TVT removal.

Safety and Efficacy of Holmium Laser Resection for Primary Nonmuscle-Invasive Bladder Cancer Versus Transurethral Electroresection: Single-Center Experience

To assess the safety and efficacy of holmium laser resection for primary, clinically nonmuscle-invasive, bladder cancer (HoLRBT) compared with standard transurethral resection of bladder tumor (TURBT). The data from a total of 212 consecutive patients with primary nonmuscle-invasive bladder cancer were collected in this study. These patients were treated by holmium laser resection (HoLRBT group) or transurethral electroresection (TURBT group) and were divided into 2 groups. The patients in each group were stratified into 3 risk subgroups (low, intermediate, and high risk) according to the prognostic factors for recurrence using the European Association of Urology guidelines. The intraoperative complications and postoperative characteristics of the HoLRBT and TURBT groups were compared. Efficacy, indicated by the recurrence-free survival in the overall group and stratified subgroups, was analyzed and compared using the Kaplan-Meier technique and the log-rank test. The patient demographics and tumor characteristics in the 2 groups were comparable. HoLRBT was superior to TURBT in terms of intraoperative complications and postoperative catheterization time (P < .001). Recurrence-free survival after HoLRBT was similar to that after TURBT (P = .283). Our results have indicated that HoLRBT is a feasible, safe, and effective alternative for the management of primary, clinically nonmuscle-invasive, bladder cancer compared with TURBT, with similar recurrence-free survival and fewer perioperative complications. It also can provide sufficient material for the pathologic evaluation.

Alternative approaches to endoscopic ablation for benign enlargement of the prostate: systematic review of randomised controlled trials

Objective To compare the effectiveness and risk profile of newer methods for endoscopic ablation of the prostate against the current standard of transurethral resection.Design Systematic review and meta-analysis.Data sources Electronic...

The Hemostatic Properties of Transurethral Plasmakinetic Resection of the Prostate: Comparison with Conventional Resectoscope in an ex vivo Study

Aim: To compare the hemostatic properties of transurethral plasmakinetic resection of the prostate (PKRP) and standard transurethral resection of the prostate (TURP) ex vivo, as perioperative bleeding is still regarded as one of the major complications of transurethral prostatectomy. Materials and Methods: Isolated normal saline (NS)-perfused porcine kidneys were used to determine the hemostatic efficacy of PKRP and TURP. The perfusion fluid loss was semiquantitatively measured in relation to tissue ablation for the two techniques and specimens were evaluated histologically. Results: The PKRP group had a significantly smaller loss of NS than the TURP group (4.16 ± 1.25 and 6.39 ± 1.05 g/min, respectively, p < 0.01). Compared with the measurements with TURP, the depths of the coagulation zones with PKRP were significantly larger (225.09 ± 35.77 and 146.84 ± 18.91 µm, respectively, p< 0.01). Conclusions: PKRP ex vivo was associated with significantly better hemostasis than TURP.

Update on photoselective vaporization of the prostate

Photoselective vaporization of the prostate (PVP) with a potassium titanyl phosphate (KTP) laser may be the most promising new technology applied to the treatment of benign prostatic hyperplasia (BPH). The specific laser light characteristics and the ideal interactions between KTP lasers and prostatic tissue result in an even and efficient vaporization of the prostate and the formation of a clearly deobstructed prostate cavity. PVP can be a day-care procedure, with few hours of catheterization and minimal postoperative discomfort, offering outcomes at least equivalent to the reference standard transurethral resection of the prostate. Although larger studies are necessary to further define where PVP stands in the management of BPH, this review focuses on contemporary treatment techniques and their limitations, and comments on the outcomes of its current use.

Open adenomectomy: past, present and future

Open surgery has been the gold standard for the treatment of benign, symptomatic, large volume prostatic hyperplasia. Recent data series, however, have demonstrated that a minimally invasive approach can be used for the treatment of this pathology while duplicating the results of the open technique. This review will describe the different surgical techniques that have been used through the last century for the treatment of benign prostatic hyperplasia, highlighting the advantages and disadvantages of each approach. Surgical management for symptomatic benign prostatic hyperplasia has made a journey from an open approach to robotic surgery. Modifications of the gold standard transurethral resection have been incorporated into clinical practice and include bipolar transurethral resection as well as holmium laser resection and potassium titanyl phosphate laser vaporization. Minimally invasive ablative techniques have also been popularized and include transurethral needle ablation and thermotherapy. Most recently, laparoscopy has demonstrated to be a feasible, safe, reproducible technique that can create similar outcomes to an open technique whilst maintaining the advantages of a minimally invasive approach. Although the future will see greater use of robotics, larger series are needed to prove the advantages of this technology. Minimally invasive approaches for the treatment of symptomatic benign giant prostatic hyperplasia are replacing open surgery, which has been the gold standard for the surgical treatment of this pathology, duplicating its results with a lower morbidity. Recently we have seen a growing amount of experience treating this disease state with laparoscopic/robotics and the advantages it provides may permit the popularization of this technique.

Thulium Laser versus Standard Transurethral Resection of the Prostate: A Randomized Prospective Trial

ObjectiveThulium laser resection of the prostate-tangerine technique (TmLRP-TT) is a transurethral procedure that uses thulium laser fiber to dissect whole prostatic lobes off the surgical capsule, similar to peeling a tangerine. To our knowledge we report the first prospective, randomized study comparing TmLRP-TT and standard TURP for symptomatic BPH. MethodsFrom November 2004 to December 2005, 100 consecutive BPH patients were randomized for surgical treatment with TmLRP-TT (n=52) or TURP (n=48). All patients were preoperatively assessed with subjective symptoms score, International Index of Erectile Function questionnaire, and complete urodynamic evaluation. Preoperative and perioperative parameters at 1-, 6-, and 12-mo follow-up were also evaluated. All complications were recorded. ResultsTmLRP-TT was significantly superior to TURP in terms of catheterization time (45.7±25.8h vs. 87.4±33.8h, p<0.0001), hospital stay (115.1±25.5h vs. 161.1±33.8h, p<0.0001), and drop in hemoglobin (0.92±0.82g/dl vs. 1.46±0.65g/dl, p<0.001), whereas it required equivalent time to perform (46.3±16.2 vs. 50.4±20.7min, p>0.05). TmLRP-TT and TURP resulted in a significant improvement from baseline in terms of subjective symptoms scoring and urodynamic finding, but no significant difference was found between the two groups. Late complications were also comparable. ConclusionsTmLRP-TT is an almost bloodless procedure with high efficacy and little perioperative morbidity. TmLRP-TT is superior to TURP in safety and is as efficacious as TURP in 1-yr follow-up. It is a promising technology in the clinical practice field.

The long‐term results of transurethral vaporization of the prostate using plasmakinetic energy

To assess the long-term efficacy and the safety of plasmakinetic vaporization of prostate (PKVP, Gyrus Medical Ltd., Bucks, UK) against standard transurethral resection of the prostate (TURP) for symptomatic prostatic obstruction. Of 75 patients admitted to our clinic with symptomatic prostatic obstruction between 2001 and 2003, 40 who were randomized to undergo either TURP or PKVP, and who had returned for the follow-up, were included in this study. All treated patients completed the 36-months of follow-up; 25 had had PKVP and 15 a standard TURP. After surgery the treatment outcome was evaluated using the International Prostate Symptom Score (IPSS), maximum urinary flow rate (Q(max)) and long-term complications of surgery. The two groups had similar baseline characteristics. The improvement in both groups was statistically significant for the IPSS and Q(max) at 24 and 36 months vs the baseline values (P < 0.05). The mean (sd) IPSS decreased from 21 (3.4) to 7.1 (1.5) and 7.6 (1.4) after PKVP and from 22 (3.8) to 5.2 (1.1) and 5.7 (1.2) after TURP, at 24 and 36 months, respectively. The mean Q(max) for the both groups increased significantly from baseline values at 2 and 3 years, respectively, at 20.8 (2.4) and 21.8 (3.1) mL/s after TURP, which was statistically significantly better than after PKVP, at 12.5 (2.1) and 14.4 (2.6) mL/s, respectively (P < 0.05). Although three patients (12%) in the PKVP group had TURP at 14, 20 and 36 months, respectively, for residual adenoma tissue, one patient had an additional operation after TURP. Bulbar urethral strictures occurred in one patient in each group, requiring internal optical urethrotomy. Erectile dysfunction was reported by three patients after PKVP (12%) and by two of 15 after TURP who were potent before surgery (P > 0.05). The retrograde ejaculation rates in patients with erectile function were similar in both groups (56% and nine of 15, respectively; P > 0.05). In the PKVP and TURP groups, 12 (48%) and nine of 15 patients were satisfied overall. Although early results showed that PKVP was a good alternative technique among the minimally invasive methods for surgically managing prostatic obstruction, the clinical outcome of PKVP in the long term was not comparable to the results after TURP.

Comparison of Treatment Outcomes between Photoselective Vaporization and Transurethral Resection of the Prostate for Benign Prostatic Hyperplasia

Purpose: We prospectively compared the treatment outcomes of photoselective vaporization of the prostate (PVP) with those of the gold standard transurethral resection of the prostate (TURP). Materials and Methods: Between October 2004 and April 2006, a prospective clinical trial was performed with 131 and 41 patients treated by PVP and TURP, respectively. The efficacy of the two procedures were compared in terms of the International Prostate Symptom Score, quality of life score, peak urinary flow rate, postvoid residual volume, complications and perioperative outcomes at 1, 3, 6 and 12 months following treatment. Results: The baseline characteristics of the two groups were similar. The operative times, catheter indwelling times and hospital stays were significantly shorter in the PVP group. All efficacy parameters were significantly improved in both groups compared to those obtained preoperatively. In addition, the degrees of improvement in the efficacy parameters were similar between the two groups within 12 months. With respect to the prostatic volume reduction, the difference between the preand post-PVP volumes during the study period was less than that of the TURP group (p<0.001). There were no differences in the overall complications between the two groups, with the exception of more common bleeding reguiring a transfusion and capsule perforation in the TURP group. Conclusions: PVP provides excellent intraoperative and postoperative safety, and facilitates immediate relief from obstructive voiding symptoms; similarly to TURP, but has the advantages of shorter hospital stays and catheter indwelling times. The short-term treatment outcomes 12 months after PVP and TURP were comparable, with the exception of the prostatic volume reduction. (Korean J Urol 2007;48:297-303)

MP-21.15: Holmium laser enucleation of prostate with mechanical morcellation. The platinum standard

Holmium laser enucleation of prostate (HOLEP) is evolving to be an effective alternative to gold standard trans-urethral resection of prostate (TURP) or open prostatectomy for benign prostatic hyperplasia (BPH) irrespective of gland size. We report on our experience of treating 1168 patients with symptomatic BPH and their long-term outcome.

MP-21.12: A prospective randomised study between transurethral vaporisation using plasmakinetic energy and transurethral resection of prostate: five-year results

A prospective randomised study was conducted to evaluate the safety and efficacy of Plasmakinetic™ energy (Gyrus electrosurgical system) that produces vaporisation of tissue immersed in isotonic saline against standard transurethral resection of the prostate in the treatment of benign prostatic hyperplasia.

Plasmakinetic resection of the prostate versus standard transurethral resection of the prostate: a prospective randomized trial with 1-year follow-up

The aim of this study was to compare the clinical results of plasmakinetic resection of the prostate (PRP) with standard transurethral resection (TUR) of the prostate (TURP). A total of 240 patients (mean age 63.5; age range 52-90 years), with symptomatic benign prostatic hyperplasia were randomized into two groups and treated with two different techniques (TURP and PRP). We evaluated pre-operative, per-operative and post-operative (first and 12th months) findings of all patients. The mean catheterization time was 3 and 4.5 days in the PRP and standard TURP groups, respectively (P<0.001). We observed the improvements in maximum flow rates in PRP group were significantly higher than TURP group (P<0.001). TUR of the prostate using plasmakinetic energy seems to be a promising treatment alternative to conventional TURP. It has the advantages of low intraoperative and post-operative complications, short convalescence, excellent intraoperative hemostasis, absence of fluid absorption and TUR syndrome.

A Prospective, Randomized Trial Comparing Conventional Transurethral Prostate Resection With PlasmaKinetic® Vaporization of the Prostate: Physiological Changes, Early Complications and Long-Term Followup

We compared standard transurethral prostate resection with bipolar PlasmaKinetic prostate vaporization for bladder outflow obstruction using a Gyrus PlasmaKinetic Plasma V bar. A total of 160 men were enrolled in a prospective, randomized trial. Those at higher risk for cancer were excluded by prostate specific antigen and digital rectal examination with or without transrectal ultrasound biopsy. A total of 81 men underwent prostate vaporization and 79 underwent transurethral prostate resection. Preoperative International Prostate Symptom Score and quality of life score, uroflowmetry, post-void residual urine and transrectal ultrasound prostate volume were recorded. Preoperative and postoperative serum hemoglobin, hematocrit and sodium were measured. Perioperative fluid absorption was calculated using weighing on table and blood loss using the Hemocue system. Longer followup of International Prostate Symptom Score and quality of life score, uroflowmetry and post-void residual urine was available in 149 men, including 76 who underwent prostate vaporization and 73 who underwent transurethral prostate resection. Data were analyzed using the 1 or 2-sample t and chi-square tests. The 2 groups were comparable in all preoperative parameters. Perioperative fluid absorption, intraoperative blood loss, preoperative and postoperative serum hematocrit, and sodium changes were not statistically different. Mean resection time was 4 minutes shorter for transurethral prostate resection (28.5 vs 32.6 minutes, p = 0.08). Patients with transurethral prostate resection showed a greater hemoglobin decrease (1.39 vs 0.8 gm/dl, p = 0.002) and required more irrigation postoperatively (28.3 vs 20.4 l, p = 0.001). Four patients with transurethral prostate resection required transfusion compared with none who underwent prostate vaporization. After transurethral prostate resection hospital stay was longer (3.36 vs 3.02 days, p = 0.03). Cancer was detected in 8 patients with transurethral prostate resection (10%), of whom 7 are under prostate specific antigen surveillance and 1 received radical radiotherapy. Mean long-term followup was 258 days (range 82 to 884). Prostate vaporization and transurethral prostate resection were equally effective at followup, as evidenced by changes in maximum urine flow, International Prostate Symptom Score, quality of life score and post-void residual urine. The 2 operations are highly effective in experienced hands. PlasmaKinetic prostate vaporization resulted in less postoperative bleeding and a slightly shorter hospital stay. The lack of a histological specimen with this version of PlasmaKinetic prostate vaporization may mean that clinically significant cancers are missed.

Transurethral microwave thermotherapy for the treatment of BPH: still a challenger?

Minimally invasive therapies for treatment of benign prostatic hyperplasia (BPH) compete with the gold standard transurethral resection of the prostate (TURP). Comparisons of efficacy and safety have broadened the knowledge of different treatment modalities. Concerns of quality of life such as unaltered sexual function as well as cost considerations drive the market to develop techniques of lower level invasiveness. Among the competitors the office based transurethral microwave thermotherapy (TUMT) provides the broadest scale of scientific data. Numerous manufacturers sell various modifications of this technology. According to different clinical studies TUMT proved to be an effective, safe, and durable therapy for the treatment of lower urinary tract symptoms (LUTS) secondary to BPH. However, TURP still holds the steadier long-term results and is more effective to reduce obstruction as well as other LUTS.

Prospective Randomized Controlled Trial Comparing Plasmakinetic Vaporesection and Conventional Transurethral Resection of the Prostate

OBJECTIVE: Plasmakinetic vaporesection of the prostate (PKVP) using normal saline irrigation has the theoretical advantage of avoiding transurethral resection syndrome and minimizing blood loss. It may also shorten the operative time since tissue is resected instead of just vaporized. The aim of this study was to evaluate the efficiency, safety and advantages of PKVP compared with standard transurethral resection of the prostate (TURP) at a regional acute hospital. METHODS: A total of 60 consecutive men admitted from a waiting list for surgery for benign prostatic hyperplasia (BPH) were prospectively randomized to either PKVP or TURP. Peri- and postoperative outcome data at 3 months were obtained. RESULTS: The PKVP loop achieved a fast and sharp cutting action similar to that with the traditional TURP loop. Data analysis was based on 51 patients. There were no significant differences between the methods in resection time, postoperative catheterization time and hospital stay. The mean reductions in serum sodium 2 hours after PKVP and on postoperative day 1 were 0.52 mmol/L and 3.35 mmol/L, respectively, while mean reductions in haemoglobin were 0.36 g/dL and 0.24 g/dL, respectively. There was no significant difference in haemoglobin reductions between PKVP and TURP (p = 0.326 at 2 hours; p = 0.192 on day 1) and serum sodium (p = 0.757 at 2 hours; p = 0.888 on day 1). Both groups achieved comparable improvement in International Prostate Symptom Score (p = 0.862), quality-of-life score (p = 0.169) and peak flow rate (p = 0.96) at 3-month follow-up. CONCLUSION: PKVP achieved comparable results to traditional TURP and was an effective and safe procedure. However, it did not demonstrate obvious advantages over TURP in this acute regional hospital regular TURP list setting. [Asian J Surg 2005;28(1):24–8]

Transurethral Electrovapor Resection versus Standard Transurethral Resection Treatment for a Large Prostate: A 2-Year Follow-Up Study Conducted in Taiwan

Introduction: Those patients featuring a large prostate and undergoing transurethral resection typically face a longer duration of surgery, they have a higher degree of hemorrhage and a higher irrigant volume required for the procedure, and they tend to reflect a higher incidence of morbidity than is the case for a small prostate. We report on the relative safety and efficacy of transurethral electrovapor resection of the prostate (TUVRP) as compared with standard transurethral resection of the prostate (TURP) for Taiwanese patients having a prostate size >50 ml. Patients and Methods: Seventy-six symptomatic benign prostatic hyperplasia patients featuring a prostate size >50 ml were randomized and underwent either TUVRP using wedge loop or standard TURP. Perioperative parameters, treatment outcome, and adverse events associated with the surgical procedure are assessed herein. Results: Mean operation time, changes in hemoglobin levels, resected prostate weight, perioperative irrigant volume needed, and incidences of recatheterizations and readmissions, all differed significantly when the two surgical procedures were compared. The average expense differences for the two procedures were impressive (p < 0.0001). No postoperative intergroup sexual dysfunction differences were noted. Clinical improvements following either TUVRP or TURP were significant and sustained for at least a period of 2 years. Intergroup comparison of International Prostate Symptom Score, quality of life, peak flow rate, and postvoid residual volume revealed no significant differences at 2 years (p = 0.45, 0.48, 0.12, and 0.29, respectively). The need for postoperative medical retreatment and/or reoperation did not differ significantly between the two groups (p = 0.62 and p = 0.56, respectively, at 6 months and p = 0.47 and p = 0.48, respectively, at 2 years). Conclusions: The TUVRP procedure offers advantages as regards a number of perioperative parameters when compared with the TURP procedure, and it seems that TUVRP might provide at least an equivalent treatment outcome as is the case for TURP.

Efficacy of Bipolar Transurethral Resection of the Prostate: Comparison with Standard Monopolar Transurethral Resection of the Prostate

Purpose: We wanted to assess the efficacy of bipolar transurethral resection of the prostate (TURP) compared with standard monopolar TURP. Materials and Methods: All 25 patients with symptomatic benign prostatic hyperplasia (BPH) who underwent TURP from July 2004 to June 2005 were retrospectively reviewed. Thirteen consecutive patients underwent standard monopolar TURP and 12 underwent bipolar TURP using the Gyrus PlasmaKinetic system. Results: The mean weight of resection was 29.7g for the bipolar TURP and 22.5g for the monopolar TURP. The operative time was shorter (82.5 vs 98.1 minutes, respectively), the estimated blood loss was less (252 vs 268cc, respectively) and the mean post-operative hospital stay was shorter (5.3 vs 5.7 days, respectively) in the bipolar TURP group. However, these differences were not statistically significant. The acute complications were significant hyponatremia in one patient and clot retention in one patient after monopolar TURP, but no complications occurred after bipolar TURP. The maximal flow rate increased from 6.4 to 14.7ml/sec in the bipolar TURP group, and it increased from 6.7 to 15.2ml/sec in the monopolar TURP group. Conclusions: Compared to monopolar TURP, bipolar TURP can be easily and safely used for treating symptomatic BPH with less morbidity. (Korean J Urol 2006;47:377-380) ꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏ