title: A Prospective Randomized Study Comparing Disposable with Reusable Blades for a Morcellator Device.
abstract: Transurethral enucleation of the prostate for the management of benign prostatic obstruction (BPO) involves two steps: the enucleation and morcellation procedure. The aim of our study was to assess the efficacy of a morcellator device using disposable and reusable blades with different settings of morcellation speed.
  
  
  
  A prospective randomized study was initiated for patients with symptomatic BPO undergoing Thulium laser enucleation of the prostate. Mechanical tissue morcellation was performed using the Piranha™ morcellator (R. Wolf, Knittlingen, Germany) with disposable or reusable blades at 850 (n = 24) or 1500 revolutions per minute (rpm) (n = 24). Patient characteristics, intraoperative complications, and the morcellation rate (g/min) were recorded. Data are expressed as median and interquartile range (IQR).
  
  
  
  Forty-eight patients were randomized using disposable (n = 24) or reusable blades (n = 24). For reusable blades, the morcellation rate did not increase when changing the morcellation speed from 850 to 1500 rpm (5 vs 4.53 g/min, p = 0.843). The morcellation rate increased significantly when changing the morcellation speed from 850 to 1500 rpm using single-use blades (4.77 vs 10 g/min, p ≤ 0.014). The morcellation rate was not different at 850 rpm between reusable and single-use blades (5 vs 4.77 g/min, p = 0.671). Conversely, the morcellation rate was significantly different at 1500 rpm between reusable and single-use blades (4.53 vs 10 g/min, p ≤ 0.017). The total morcellation rate (at 850 and 1500 rpm) was significantly increased using single-use blades compared to reusable blades (7.67 vs 4.8 g/min, p ≤ 0.026). Interestingly, enucleated weight (g) and the morcellation rate (g/min) correlated inversely using single-use blades at 1500 rpm (r = -0.742, p ≤ 0.004). Only one superficial bladder injury occurred at 1500 rpm, which needed no further interventions.
  
  
  
  The Piranha morcellator facilitates efficient tissue removal with single-use and reusable blades. Disposable morcellator blades increase tissue removal significantly at 1500 rpm.
authors.affiliation: Department of Urology, Asklepios Hospital Barmbek , Hamburg, Germany .
authors.forename: Benedikt
authors.initials: B
authors.lastname: Becker
authors.affiliation: Department of Urology, Asklepios Hospital Barmbek , Hamburg, Germany .
authors.forename: Ann Katrin
authors.initials: AK
authors.lastname: Orywal
authors.affiliation: Department of Urology, Asklepios Hospital Barmbek , Hamburg, Germany .
authors.forename: Teresa
authors.initials: T
authors.lastname: Hausmann
authors.affiliation: Department of Urology, Asklepios Hospital Barmbek , Hamburg, Germany .
authors.forename: Andreas J
authors.initials: AJ
authors.lastname: Gross
authors.affiliation: Department of Urology, Asklepios Hospital Barmbek , Hamburg, Germany .
authors.forename: Christopher
authors.initials: C
authors.lastname: Netsch
mesh_terms: D000368:Aged; D004209:Disposable Equipment; D017743:Equipment Reuse; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D000069577:Morcellation / Q000295:instrumentation*; D011446:Prospective Studies; D011470:Prostatic Hyperplasia / Q000601:surgery*; D020728:Transurethral Resection of Prostate / Q000295:instrumentation*
keywords: benign prostate obstruction; enucleation; laser; morcellation; piranha morcellator; thulium