title: Bipolar transurethral resection in saline (TURis): outcome and complication rates after the first 1000 cases.
abstract: 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.
authors.affiliation: Department of Urology ASL1 Liguria, Imperia, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Puppo
authors.forename: Franco
authors.initials: F
authors.lastname: Bertolotto
authors.forename: Carlo
authors.initials: C
authors.lastname: Introini
authors.forename: Francesco
authors.initials: F
authors.lastname: Germinale
authors.forename: Luca
authors.initials: L
authors.lastname: Timossi
authors.forename: Angelo
authors.initials: A
authors.lastname: Naselli
mesh_terms: 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*
chemical_list: D012965:Sodium Chloride