Bipolar transurethral resection in saline (TURis): outcome and complication rates after the first 1000 cases.
OBJECTIVE
TURis((R)) is an emerging technique that shows the same efficacy of monopolar resection. However, there is currently little available data on the safety of bipolar devices. We assessed outcome and safety of TURis on a large cohort of patients with at least 6 months' follow-up.


METHODS
Between January 2006 and October 2007, 1000 consecutive transurethral resection (TUR), 376 transurethral resection of prostate, 480 transurethral resection of bladder neoplasm, and 144 transurethral incision of prostate were performed. All procedures were carried out with a bipolar device in physiologic saline (TURis). The resectoscope used was an Olympus 26F in continuous flow-type Iglesias with continuous aspiration. The loops were all disposable/single use. The incidence of unwanted stimulation of the obturator reflex, TUR syndrome, thermal skin lesion, blood transfusion, urethral strictures, and bladder neck contractures were recorded.


RESULTS
None of the patients operated experienced a TUR syndrome or a thermal skin lesion. The median follow-up of the entire cohort was 12 months (range, 6-24 months); 663 patients had at least 1-year follow-up (66.3%). Urethral stricture occurred in 27 patients (2.7%). Four patients developed a bladder neck contracture after transurethral resection of prostate (1%). Early postoperative clot retention occurred in 21 patients (2.1%), and 11 patients needed one or more transfusion (1.1%). Only six patients (2%) submitted to TUR of a neoplastic lesions at the lateral bladder wall experienced an unwanted trigger of the obturator reflex.


CONCLUSIONS
TURis offers the patient the same results as monopolar technology guaranteeing maximum safety without increasing the incidence of urethral strictures.
Puppo
Paolo
P
Department of Urology ASL1 Liguria, Imperia, Italy.
Bertolotto
Franco
F
Introini
Carlo
C
Germinale
Francesco
F
Timossi
Luca
L
Naselli
Angelo
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D011467:Prostate / Q000601:surgery; D012965:Sodium Chloride / Q000627:therapeutic use*; D016896:Treatment Outcome; D014521:Urethra / Q000601:surgery*; D001749:Urinary Bladder Neoplasms / Q000601:surgery; D013520:Urologic Surgical Procedures / Q000009:adverse effects*
D012965:Sodium Chloride