Bipolar transurethral resection of prostate: clinical and urodynamic evaluation.
OBJECTIVE
To report our experience with the clinical effectiveness of endoscopic resection of the prostate using the bipolar Gyrus PlasmaKinetic System.


METHODS
A total of 120 patients with lower urinary tract symptoms were observed from 2002 to 2005. Of these 120 patients, 90 developed benign prostatic hyperplasia and were considered to have obstruction, and 51 of these 90 were scheduled for prostate surgery. The patients were randomized 1:1, using envelopes, into two groups: bipolar transurethral resection of the prostate (TURP) using the Gyrus PlasmaKinetic System (PK group) and monopolar TURP (standard TURP group). All patients were evaluated at baseline and follow-up (12 months after treatment) by medical history, International Prostate Symptom Score, inclusive of the question on quality of life, and physical examination, including digital rectal examination, transrectal ultrasonography, and pressure flow study. Statistical analysis was applied on the change in International Prostate Symptom Score and urodynamic parameters comparing the endpoints with baseline and comparing the baseline and follow-up characteristics between the two groups.


RESULTS
The mean resection time was 39.1 minutes and 31.7 minutes for the PK and standard TURP groups, respectively (P = 0.437). The mean postoperative hemoglobin reduction at 24 hours of follow-up was 1.25 g/dL, with a 2.1% hematocrit reduction, in the PK group and 1.81 g/dL, with a 3.2% hematocrit reduction, in the standard TURP group (P = 0.716). Improvements in flow rate, International Prostate Symptom Score, quality-of-life score, and bladder outlet obstruction grade were comparable between the two groups.


CONCLUSIONS
Bipolar TURP using the bipolar Gyrus PlasmaKinetic System seems to be a safe and effective procedure that is potentially associated with fewer side effects and could result in this procedure being more attractive for high-risk patients or, as recently proposed, for training purposes.
Iori
Francesco
F
Department of Urology, University of Rome La Sapienza, Rome, Italy.
Franco
Giorgio
G
Leonardo
Costantino
C
Laurenti
Cesare
C
Tubaro
Andrea
A
D-Amico
Francesco
F
Dini
Danilo
D
De Nunzio
Cosimo
C
D000368:Aged; D004598:Electrosurgery; D004724:Endoscopy; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011470:Prostatic Hyperplasia / Q000503:physiopathology* / Q000601:surgery*; D020728:Transurethral Resection of Prostate / Q000379:methods*; D014563:Urodynamics