A hybrid technique using bipolar energy in transurethral prostate surgery: a prospective, randomized comparison.
OBJECTIVE
We assessed the efficacy and safety of transurethral resection and vaporization with bipolar PlasmaKinetic energy.


METHODS
During a 2-year period 101 men with benign prostatic hyperplasia were randomly assigned to PlasmaKinetic surgery or standard transurethral prostate resection (TURP). Patient demographics, indications for surgery, preoperative and postoperative International Prostate Symptom Score, uroflowmetry scores, operative time, catheterization duration, hospital stay and complication rates were compared.


RESULTS
Complete data on 96 patients with a mean age +/- SD of 69.1 +/- 6.1 years was available at a mean followup of 18.3 +/- 6.7 months (range 12 to 23). In the PlasmaKinetic and TURP groups mean operative time was 40.3 +/- 11.4 (range 30 to 60) and 57.8 +/- 13.4 minutes (range 45 to 75), respectively (p <0.01). The mean volume of saline irrigation during the PlasmaKinetic procedure was significantly lower than that of hyperosmolar solution irrigation during TURP (p <0.05). Patients in the PlasmaKinetic and TURP groups were catheterized a mean of 2.3 +/- 0.7 (range 2 to 4) and 3.8 +/- 0.7 days (range 3 to 5), respectively (p <0.05). The mean improvement rate from baseline at month 12 in International Prostate Symptom Score and the maximal urinary flow rate was similar in the 2 groups. Severe irritative symptoms were the most common complaints after PlasmaKinetic surgery, as observed in 6 cases (12.2%). Recatheterization was necessary in 3 cases (6.1%) cases in the PlasmaKinetic group and in 1 (2.1%) in the TURP group. During followup urethral stricture formation was observed in 3 patients (6.1%) cases in the former group and in 1 (2.1%) in the latter group (p = 0.002). Reoperation was required in 2 (4.1%) and 1 (2.1%) cases in the PlasmaKinetic and TURP groups, respectively.


CONCLUSIONS
: Transurethral surgery with PlasmaKinetic bipolar energy seems to be a promising alternative to prostatic tissue removal with shorter operative, catheterization and hospitalization times, although increased rates of postoperative irritative symptoms and urethral stricture formation must be further evaluated.
Tefekli
Ahmet
A
Department of Urology, Haseki Teaching and Research Hospital, Istanbul, Turkey. atefekli@yahoo.com
Muslumanoglu
Ahmet Yaser
AY
Baykal
Murat
M
Binbay
Murat
M
Tas
Aytul
A
Altunrende
Fatih
F
D004564:Electrocoagulation / Q000379:methods; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011470:Prostatic Hyperplasia / Q000601:surgery*; D020728:Transurethral Resection of Prostate / Q000009:adverse effects / Q000379:methods*; D014525:Urethral Stricture / Q000209:etiology