title: Bipolar plasma vaporization using plasma-cutting and plasma-loop electrodes versus cold-knife transurethral incision for the treatment of posterior urethral stricture: a prospective, randomized study.
abstract: OBJECTIVE
  Evaluate the efficiency and safety of bipolar plasma vaporization using plasma-cutting and plasma-loop electrodes for the treatment of posterior urethral stricture. Compare the outcomes following bipolar plasma vaporization with conventional cold-knife urethrotomy.
  
  
  METHODS
  A randomized trial was performed to compare patient outcomes from the bipolar and cold-knife groups. All patients were assessed at 6 and 12 months postoperatively via urethrography and uroflowmetry. At the end of the first postoperative year, ureteroscopy was performed to evaluate the efficacy of the procedure. The mean follow-up time was 13.9 months (range: 12 to 21 months). If re-stenosis was not identified by both urethrography and ureteroscopy, the procedure was considered "successful".
  
  
  RESULTS
  Fifty-three male patients with posterior urethral strictures were selected and randomly divided into two groups: bipolar group (n=27) or cold-knife group (n=26). Patients in the bipolar group experienced a shorter operative time compared to the cold-knife group (23.45±7.64 hours vs 33.45±5.45 hours, respectively). The 12-month postoperative Qmax was faster in the bipolar group than in the cold-knife group (15.54±2.78 ml/sec vs 18.25±2.12 ml/sec, respectively). In the bipolar group, the recurrence-free rate was 81.5% at a mean follow-up time of 13.9 months. In the cold-knife group, the recurrence-free rate was 53.8%.
  
  
  CONCLUSIONS
  The application of bipolar plasma-cutting and plasma-loop electrodes for the management of urethral stricture disease is a safe and reliable method that minimizes the morbidity of urethral stricture resection. The advantages include a lower recurrence rate and shorter operative time compared to the cold-knife technique.
authors.affiliation: Renmin Hospital of Wuhan University, Department of Urology, Wuhan, Hubei, China.
authors.forename: Wansong
authors.initials: W
authors.lastname: Cai
authors.affiliation: Renmin Hospital of Wuhan University, Department of Urology, Wuhan, Hubei, China.
authors.forename: Zhiyuan
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Renmin Hospital of Fuyang, Department of Urology, Hangzhou, Zhejiang, China.
authors.forename: Liping
authors.initials: L
authors.lastname: Wen
authors.affiliation: Renmin Hospital of Fuyang, Department of Urology, Hangzhou, Zhejiang, China.
authors.forename: Xiangxin
authors.initials: X
authors.lastname: Jiang
authors.affiliation: Renmin Hospital of Wuhan University, Department of Urology, Wuhan, Hubei, China.
authors.forename: Xiuheng
authors.initials: X
authors.lastname: Liu
mesh_terms: D000368:Aged; D017115:Catheter Ablation / Q000379:methods*; D003558:Cystoscopy / Q000379:methods*; D004566:Electrodes; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D059035:Perioperative Period; D011446:Prospective Studies; D012008:Recurrence; D016896:Treatment Outcome; D014525:Urethral Stricture / Q000601:surgery*