title: Bipolar plasma vaporization versus standard transurethral resection in secondary bladder neck sclerosis: a prospective, medium-term, randomized comparison.
abstract: OBJECTIVE
  This prospective, randomized, medium-term trial aimed to assess the efficiency, safety and postoperative results of bipolar plasma vaporization (BPV) in comparison with monopolar transurethral resection (TUR) in cases of secondary bladder neck sclerosis (BNS).
  
  
  METHODS
  A total of 70 patients with BNS secondary to transurethral resection of the prostate (TURP; 46 cases), open prostatectomy for benign prostatic hypertrophy (BPH; 18 cases) and radical prostatectomy for prostate cancer (6 cases) were enrolled in the trial. The inclusion criteria consisted of maximum flow rate (Q max) <10 ml/s and International Prostate Symptom Score (IPSS) >19. All patients were evaluated preoperatively and at 1, 3, 6, 12 and 18 months after surgery by IPSS, quality of life score (QoL), Q max and postvoiding residual urinary volume (PVR).
  
  
  RESULTS
  The mean operation time (10.3 versus 14.9 minutes), catheterization period (0.75 versus 2.1 days) and hospital stay (1.1 versus 3.2 days) were significantly reduced in the BPV series. During the immediate postoperative follow up, recatheterization for acute urinary retention only occurred in the TUR series (5.7%). The medium-term retreatment requirements due to BNS recurrence were lower in the BPV study arm (2.8% versus 8.5%). At the 1, 3, 6, 12 and 18 months assessments, statistically similar parameters were found concerning the IPSS and QoL symptom scores, Q max and PVR values specific for the two therapeutic alternatives.
  
  
  CONCLUSIONS
  BPV constitutes a valuable endoscopic treatment approach for secondary BNS. The method emphasized superior efficacy, a satisfactory safety profile and similar medium-term follow-up features when compared with standard TUR.
authors.affiliation: 'Saint John' Emergency Clinical Hospital, Department of Urology, Bucharest, Romania.
authors.forename: Bogdan
authors.initials: B
authors.lastname: Geavlete
authors.forename: Cristian
authors.initials: C
authors.lastname: Moldoveanu
authors.forename: Catalin
authors.initials: C
authors.lastname: Iacoboaie
authors.forename: Petrisor
authors.initials: P
authors.lastname: Geavlete
keywords: bipolar plasma vaporization; monopolar transurethral resection; secondary bladder neck sclerosis.
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