Clinical and technical aspects of bipolar transurethral prostate resection.
This review aims to provide an overview and critical assessment of the developments in transurethral electroresection in non-conductive and conductive irrigants. In the 1970s, measurements of the electric pathway in saline were performed for different locations of the neutral electrode. It was then concluded that the current pathway and the possible hazards of burn injuries to the patient should be investigated separately for each arrangement of the neutral electrode. The position and shape of the neutral electrode have decisive effects on the current flow in the patient. Thus, different electrode arrangements of the various bipolar resection systems need to be analysed separately. Furthermore, not only electrical power, but also conductivity and quality of the lubricant gel have to be considered as critical factors with regard to electrothermal injuries of the urethra. The supposedly better cutting quality seems to be based more on subjective observations than on scientific valid data. When performing "bipolar" TUR it is necessary to consider all electrotechnical and clinical aspects, particularly with regard to the potential risk of thermoelectrical urethral damage.
Faul
Peter
P
Department of Urology, University Hospital Grosshadern, Ludwig-Maximilians-University Munich, Munich, Germany. Peter.faul@t-online.de
Schlenker
Boris
B
Gratzke
Christian
C
Stief
Christian G
CG
Reich
Oliver
O
Hahn
Robert Gustaw
RG
D004553:Electric Conductivity; D006801:Humans; D054327:Lubricants; D008297:Male; D012307:Risk Factors; D007507:Therapeutic Irrigation; D020728:Transurethral Resection of Prostate / Q000009:adverse effects* / Q000379:methods*; D014521:Urethra / Q000293:injuries
D054327:Lubricants