Short-term results of rotoresection for benign prostatic hyperplasia: a prospective study of safety and efficacy.
OBJECTIVE
To assess the safety and efficacy of rotoresection as a method for treating benign prostatic hyperplasia (BPH).


METHODS
Thirty patients were prospectively enrolled between September 2000 and May 2001 (mean age 61 years, sd 6, range 52-78). All patients had a symptom score (AUA) of > 12, a maximum urinary flow rate (Qmax) of < 12 mL/s, a prostate of 20-80 mL and a prostate-specific antigen (PSA) level of 0-4 ng/mL. Patients with prostate or bladder cancer, a PSA level of > 10 ng/mL, previous prostate surgery, previous pelvic surgery, urethral stricture, active urinary tract infection (UTI), acute urine retention, neuropathic bladder and a serum creatinine of > 1.8 mg/mL were excluded. The adenoma was resected using the Rotoresect system (Karl Storz, Tuttlingen, Germany); the mean (sd) operative duration was 45.2 (9.9) min. The catheter was removed after 1.97 (0.3) days and patients assessed at 1, 3 and 6 months after surgery by an AUA score, Qmax, blood haemoglobin level, urine analysis and transrectal ultrasonography; all patients but two completed the follow-up.


RESULTS
At 6 months the mean (sd) AUA score decreased from 20.5 (3.8) to 1.6 (1.3), the Qmax increased from 8.7 (2) to 25.3 (12.6) mL/s, and the total prostate volume decreased from 36.5 (13) to 20.5 (7.8) mL. The mean initial haemoglobin level was 138 (10) g/L and at 1 month was 135 (12) g/L. No patient required a blood transfusion or had signs of transurethral resection syndrome. Early complications included UTI and mild stress incontinence in 10 and 11 patients, respectively. At 6 months these patients had sterile urine and were continent. Two patients had a urethral stricture and posterior urethral stone at 6 months and were treated successfully.


CONCLUSIONS
In the short-term, rotoresection is a safe and effective method for treating BPH; there was no significant blood loss or resection syndrome. The hospital stay was short, with excellent functional results.
Wadie
B S
BS
Urology & Nephrology Centre, Mansoura, Egypt. bwadie@netscape.net
Shehab El-Dein
A B
AB
Mohamed
A M
AM
Elhalwagy
S M
SM
Ghoneim
M A
MA
D000368:Aged; D000369:Aged, 80 and over; D004598:Electrosurgery / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D004867:Equipment Design; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000628:therapy; D011446:Prospective Studies; D011470:Prostatic Hyperplasia / Q000601:surgery*; D012449:Safety; D016896:Treatment Outcome