Comparison of plasmakinetic transurethral resection of the prostate with monopolar transurethral resection of the prostate in terms of urethral stricture rates in patients with comorbidities

Abstract

PurposeTo compare urethral stricture rates in comorbid patients undergoing plasmakinetic transurethral resection of the prostate (PK-TURP) and monopolar transurethral resection of the prostate (M-TURP) for benign prostatic hyperplasia.MethodsThe data of 317 patients with comorbidities undergoing either PK-TURP or M-TURP from September 2008 to December 2012 were retrospectively evaluated. Preoperative and postoperative 12-month International Prostate Symptom Score, maximal flow rate, postoperative International Index of Erectile Function scores, and urethral stricture rates were evaluated.ResultsA total of 154 patients underwent M-TURP and 163 patients underwent PK-TURP. Urethral stricture rates were 6/154 in the M-TURP treatment arm and 17/163 in the PK-TURP treatment arm (P=0.000). In the presence of hypertension and/or coronary artery disease and/or diabetes mellitus, the risk of urethral stricture complication was significantly higher in the PK-TURP group than in the M-TURP group (P=0.000).ConclusionsThe risk of urethral stricture increases with PK-TURP in elderly patients with a large prostate and concomitant hypertension and/or coronary artery disease and/or diabetes mellitus. Therefore, PK-TURP should be performed cautiously in this group of benign prostatic hyperplasia patients.

Bipolar TURP in high-risk patients with large prostate gland: our experience

“…Post-procedure serum sodium concentration in our patients had a mean drop of 0.98±0.75 mEq/L. 2-hour post-procedure (mg/dL) serum sodium level was lower in the B-TURP group vs monopolar group (-4.4±4.3 and -10.8±4.4, respectively, p=0.00) as reported in their study by Sinanoglu et al 15 Although larger glands were operated using B-TURP, still the postoperative serum sodium drop is not that severe and is statistically significant when compared with literature regarding fall in serum sodium after M-TURP. B-TURP leads to less decline in serum sodium levels and virtually eliminates the risk of TUR syndrome.…”

“…PVRU (ml) of our patients measured with transabdominal USG was 113.45±16.5. PVRU of 126.63±17.84 and 131.5±73.7 mL was reported by other investigators in their B-TURP group respectively 13,15. …”

“…The peak flow reported in literature for monopolar TURP and bipolar TURP varies from 4.2 to 10.9 ml/s and 4.4 to 10.9 ml/s respectively. 13,14 13,15 No TUR syndrome was observed in our patients.…”

“…TURP 12,15,15. Giulianelli et al reported a hospital stay for M-TURP and B-TURP was 72±48 hour and 48±6 hour respectively.17 Follow up of patients was done with PVRU and Q max at 6 weeks and 6 months, and we had 2 patients (4.44%) who developed urethral stricture in this period and these patients were managed with urethral dilatation.…”

Comparing the short - term outcomes and complications of monopolar and bipolar transurethral resection of bladder tumors in patients with coronary artery disese: a prospective, randomized, controlled study

“…Recently, the bipolar resectoscope used for TUR of the prostate (TURP) was introduced for the treatment of bladder tumors ( 2 ). Bipolar technologies allow the electric current to complete the circuit without passing through the patient ( 4 ). By this way, saline solution can be used instead of glycine for irrigation during resection.…”