The Band Electrode: ongoing experience with a novel TURP loop to improve hemostasis in 265 patients.
BACKGROUND
Intraoperative bleeding, one of the major complications of conventional transurethral resection of the prostate (TURP), has led to a search for various alternative methods of tissue ablation in patients with benign prostatic hyperplasia. In 1996, we introduced the newly designed Band Electrode, which combines a high degree of resection efficiency with a better hemostasis.


METHODS
265 consecutive patients with prostatism underwent TURP with the Band Electrode. This modified loop electrode does not consist of a thin wire but is rather a flat metal band with a width of 1.2 mm. International prostate symptom score (IPSS), Life Quality Index (L), peak urine flow and postvoid residual urine were evaluated pre- and postoperatively. Additionally, electrical parameters have been recorded with a specially designed high-frequency generator.


RESULTS
Median IPSS decreased from 23 preoperatively to 8 and 9 at 12 (n = 194) and 24 months (n = 172), respectively (p < 0.001). Life Quality Index (L) dropped from 4 to 2 and 2, respectively (p < 0.001). Peak urine flow increased from 8.2 ml/s to 18.2 (at postoperative day 3), 17.8 and 17.4 ml/s, respectively (p < 0.001). Median postvoid residual urine decreased from 77 to 15, 22 and 21 ml, respectively (p < 0.001). Resected tissue mass averaged 25 (8-102) g, resection time was 36.5 (18-82) min. Indwelling catheters were removed 32 (24-72) h postoperatively. None of the patients required blood transfusions or showed signs of a TUR syndrome. Despite a 1.3 times higher power need, the total energy application in vivo was comparable to conventional TURP.


CONCLUSIONS
This simple exchange of active electrodes leads to a superior hemostasis and thus safety in TURP. Resection speed, tissue ablation and total energy need remain identical.
Reich
Oliver
O
Department of Urology, Ludwig-Maximilians University, Munich, Germany. oreich@uro.med.uni-muenchen.de
Faul
Peter
P
D000368:Aged; D000369:Aged, 80 and over; D004566:Electrodes; D004867:Equipment Design; D006489:Hemostatic Techniques; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D020728:Transurethral Resection of Prostate / Q000295:instrumentation*