title: Thick loop prostatectomy in the endoscopic treatment of benign prostatic hyperplasia: results of a prospective randomised study.
abstract: OBJECTIVE
  The thick loop is a new device employed for transurethral resection of the prostate (TURP) using the standard resectoscope. The loop is broader and thicker than the standard one, resulting in better hemostasis because of its ability to cut, coagulate and vaporize tissue simultaneously. We evaluated the safety and efficacy of the thick loop device compared with the standard loop.
  
  
  METHODS
  103 patients with symptomatic benign prostatic hyperplasia were randomized to undergo either thick loop (51 patients) or standard loop TURP (52 patients). Patients were considered for surgery with the American Urological Association (AUA) symptom score greater than 7 and a maximum urinary flow rate <15 ml/s. Serum hemoglobin, hematocrit, electrolytes, operative time, prostate resected weight, catheterization time and complications were recorded. Twelve months later, the AUA score, maximum urinary flow rate (Q(max)) and postvoiding residual urine volume were evaluated.
  
  
  RESULTS
  There were no significant differences between thick and standard loop TURP regarding the operative and catheterization time, prostate resection weight and postoperative levels of hemoglobin, hematocrit and electrolytes. Twelve months after TURP, the AUA score was significantly lower and Q(max) greater in the thick loop compared to the standard loop groups.
  
  
  CONCLUSIONS
  Thick loop TURP is as safe as standard loop TURP with respect to blood loss, operative time and complications. Operating in a virtually bloodless field could allow a more radical TURP and provide an explanation for the better functional results (Q(max) and AUA score) obtained by the thick loop resection.
authors.affiliation: Urology Department, Catholic University School of Medicine, Rome, Italy. ale.daddessi@libero.it
authors.forename: Alessandro
authors.initials: A
authors.lastname: D'Addessi
authors.forename: Angelo
authors.initials: A
authors.lastname: Porreca
authors.forename: Nazario
authors.initials: N
authors.lastname: Foschi
authors.forename: Marco
authors.initials: M
authors.lastname: Racioppi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004724:Endoscopy; D004867:Equipment Design; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011468:Prostatectomy / Q000295:instrumentation* / Q000379:methods; D011470:Prostatic Hyperplasia / Q000601:surgery*