A Prospective Randomized Study for Comparing Bipolar Plasmakinetic Resection of the Prostate with Standard TURP

Abstract

Objectives: To compare clinical results of plasmakinetic (PK) resection vs. standard monopolar resection of the prostate, i.e. transurethral resection of the prostate (TURP). Materials and Methods: 48 patients were included in this study between January 2003 and October 2003. They were randomized into two groups (TURP:PK) with a ratio of 1:1. PK resections (n = 24) were carried out by using PlasmaKinetic Tissue Management System (Gyrus Medical Ltd, Cardiff, UK) and PlasmaSect electrodes. TURPs (n = 24) were done by using a 26-Fr continuous-flow resectoscope and Karl Storz 27040 electrodes. Patients were assessed for safety and efficacy by measuring the IPSS and maximum flow rates at 1, 3, 6 and 12 months and residual urine measurement at 3, 6 and 12 months and transrectal ultrasonography at 6 months. Results: The patients’ ages ranged from 50 to 82 (mean 64 ± 10) years. Groups were similar for operation time, bleeding score, resected tissue, catheterization time and irrigated volume. Mean serum Na levels at the end of the operation were 141.7 ± 5.1 in the TURP group and 145.2 ± 4.4 in the PK group (p = 0.013). The IPSS, QOL score and Q_max had improved significantly in the postoperative period without any differences in either group. Conclusions: The main advantage of PK resection seems to be decreasing the risk of TUR syndrome, thus, larger prostates could be treated without a time limitation, theoretically. However, this technique brings no advantages in terms of intra- and postoperative bleeding, hospital stay, operation time and late complications.

Plasmakinetic resection of the prostate versus standard transurethral resection of the prostate: a prospective randomized trial with 1-year follow-up

“…Evaluation of the I-PSS scores revealed improvement in I-PSS score as 77% on first month and 81% on 12th months. In the other study related with these parameters, Seckiner et al 5 was found these values for I-PSS and QOL score, 64 and 60%, respectively at postoperative 12th month. The authors found comparable post-operative results to those obtained with standard TURP.…”

“…Using saline as irrigation fluid during resection and vaporization prevents aforementioned complication in the PRP. 5 A successful outcome for the patient with prostatic pathologies needs removal enough tissue, for this purpose, better visual conditions must be provided. This system enables resection of the tissue and controls the bleeding in same time.…”

Bipolar versus monopolar TURP: a prospective controlled study at two urology centers

“…By 2007, the median number of years of experience in urology was 10 years (range [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. Patients in both study arms were treated by the same surgeons.…”

“…2,9,11,15 The duration of surgery, improvement in Q-max, residual urine volume, IPSS and QoL score have, however, been reported as similar to the monopolar approach. 12,14 …”

Comparative outcomes of plasmakinetic versus monopolar transurethral resection of benign prostatic hyperplasia: 7 years' results

“…Thus, the risk of electrolyte imbalance and development of preoperative TUR syndrome are eliminated. [4][5][6] There are many publications comparing monopolar TURP and plasmakinetic TURP in the literature. The results after a 1-year follow-up were first reported in a prospective randomized trial in 2007, and the study compared standard monopolar and bipolar TURP using the plasmakinetic method.…”