title: "Tips and tricks" in secondary bladder neck sclerosis' bipolar plasma vaporization approach.
abstract: BACKGROUND
  Secondary bladder neck sclerosis (BNS) represents a common late complication of prostate surgery, however so far insufficiently assessed in the available literature. More over, the previously attempted and analyzed therapeutic modalities failed to achieve acknowledgement as standard treatment for this particular pathology.
  
  
  METHODS
  The bipolar plasma vaporization (BPV) was introduced as a viable mean of removing the obstructing scar formation in a gradual fashion. Several "tips and tricks" were described as particularly useful in optimizing the plasma corona vaporization effect. The proper BPV technique is simple and safe while closely relying on certain surgical steps, the simultaneous vaporization and coagulation processes and a superior endoscopic vision. Recent technological advances created the premises for further improvements.
  
  
  RESULTS
  The plasma-button vaporization is characterized by a satisfactory surgical speed, remote intraoperative bleeding risks, high-quality endoscopic visibility as well as the achievement of a complete sclerotic tissue removal. Within a short learning curve, a superior final aspect of the prostatic fossa and bladder neck is obtained at the end of surgery. The continuous plasma vaporization mode provides additional technical advantages. The previously described drawbacks of transurethral incision or resection seem to have been overcome by the practical features of the plasma vaporization process.
  
  
  CONCLUSIONS
  The BPV technique outlines a promising modality of efficiently ablating the obstructing fibrous tissue in secondary BNS patients. The simplicity and safety of the bipolar vaporization approach, together with the thorough obstructing scar removal in a radical fashion, create the premises for a favorable long term BPV clinical outcome.
authors.affiliation: "Saint John" Emergency Clinical Hospital, Department of Urology.
authors.forename: C
authors.initials: C
authors.lastname: Moldoveanu
authors.forename: B
authors.initials: B
authors.lastname: Geavlete
authors.forename: F
authors.initials: F
authors.lastname: Stănescu
authors.forename: M
authors.initials: M
authors.lastname: Jecu
authors.forename: L
authors.initials: L
authors.lastname: Adou
authors.forename: C
authors.initials: C
authors.lastname: Bulai
authors.forename: C
authors.initials: C
authors.lastname: Ene
authors.forename: P
authors.initials: P
authors.lastname: Geavlete
mesh_terms: D016063:Blood Loss, Surgical / Q000517:prevention & control; D002921:Cicatrix / Q000473:pathology; D003964:Diaphragm / Q000601:surgery; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D058626:Plasma Gases / Q000627:therapeutic use*; D011467:Prostate / Q000601:surgery; D012598:Sclerosis; D001743:Urinary Bladder / Q000601:surgery*
chemical_list: D058626:Plasma Gases
keywords: bipolar plasma vaporization; bladder neck sclerosis; sclerotic tissue ablation; transurethral incision/ resection