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Purpose: Transurethral resection of the prostate (TURP) is still the gold standard for the surgical treatment of symptomatic benign prostatic hyperplasia. However, the associated morbidity and blood loss remain concerns. A coagulating intermittent cutting (CIC) device with constant voltage pulses and controlled pulse intervals was recently developed. The impact of CIC on bleeding and blood transfusion rates as well as the occurrence of the TUR syndrome were investigated.Materials and Methods: From January 2000 to July 2002, 271 consecutive patients with symptomatic benign prostatic hyperplasia underwent TURP with the CIC device. In addition to blood transfusion rates, serum hemoglobin and electrolytes were determined in all patients immediately before and after TURP.Results: The mortality rate in the 271 patients subjected to TURP was 0.0%. Mean decrease in hemoglobin after TURP was 1.08 mg/dl. Intraoperative and postoperative blood transfusions were required in 7 patients (2.6%), and clinical signs of the transurethral resection syndrome were noted in 1.1% of patients.Conclusions: Coagulating intermittent cutting dramatically improves the safety of TURP by decreasing intraoperative and postoperative blood loss, and the rate of blood transfusions. With this blood sparing device we anticipate a lower incidence of hemostatic complications from TURP.KEY WORDS: transurethral resection of prostate, blood transfusion, prostatic hyperplasia Transurethral resection of the prostate (TURP) is still the gold standard for the surgical management of symptomatic benign prostatic hyperplasia and has proven to be a highly efficient technique associated with a low mortality rate. 1-3 Despite technical advances in the last few years, morbidity associated with this technique has remained constant in the range of 15% to 18%, 1, 2, 4 -6 and intraoperative blood loss and the transurethral resection syndrome (the TUR syndrome) remain concerns. In 1996 we reported on 1,211 patients undergoing TURP with a standard 24Fr low-pressure continuous flow resectoscope, 7.6% of whom required blood transfusions due to intraoperative blood loss and/or postoperative bleeding which occurred up to 4 weeks after TURP. 2 To minimize the risk of bleeding a blood sparing device based on innovative high frequency technology was developed by Hartung et al. 6 With this device each cut results in an efficient coagulation zone in the tissue without impairing the cutting quality. 6 -8 In this study we evaluated bleeding and blood transfusion rates as well as the occurrence of the TUR syndrome in TURP performed with the new coagulating intermittent cutting (CIC) high frequency generator, and compared these rates with previous results of TURP performed with standard equipment, in particular our own retrospective data on the 1,211 consecutive patients who underwent standard TURP

OBJECTIVETo evaluate the feasibility of urinary catheter removal 10 days after a radical retropubic prostatectomy (RRP) by assessing the incidence of urinary extravasation and its effect on postoperative stricture and continence rates. PATIENTS AND METHODSDuring a 4.5-year period, 619 patients undergoing RRP were evaluated. If no extravasation was detected on gravity cystography, the urinary catheter was removed 10 days after RRP. In patients with significant extravasation the catheter was left in place for 3 weeks. Overall stricture and continence rates were recorded in patients at 3, 6 and 12 months after surgery. RESULTSThere was extravasation during cystography in 29 patients (4.6%). At 3, 6 and 12 months, continence rates after catheter removal at 10 days were 74.9%, 87.9%, and 93.6%, respectively, while in the late-removal group they were 72.4%, 84.6% and 90.9%, respectively, with no significant difference between the groups. At 3 months the overall continence rate was 74.8% and at 12 months up to 93.5%. There was no difference in stricture rates between the groups, with an overall stricture rate of 0.7%. CONCLUSIONSCatheter removal 10 days after RRP is feasible, giving excellent early and late continence rates, with low anastomotic stricture rates obtained using good surgical technique. Extravasation at 10 days was rare and with proper management did not influence the final results.

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