New Bipolar Resection Device for Transurethral Resection of the Prostate: First<i>ex-Vivo</i>and<i>in-Vivo</i>Evaluation

Wendt‐Nordahl, Gunnar; Häcker, Axel; Fastenmeier, K.; Knoll, Thomas; Reich, Oliver; Alken, P.; Michel, Maurice Stephan

doi:10.1089/end.2005.19.1203

Cited by 48 publications

(24 citation statements)

References 20 publications

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“…One explanation might be that the cutting loop of the gyrus device is slightly smaller than the standard resection loop. Another attempt to explain the slower resection speed (0.44 vs. 0.56 g/min) with the bipolar method is that there is a small delay (0.8 s) [23] with each cut until the plasma corona is formed. We found two trials that also reported longer operating times with the bipolar system [9,24].…”

Section: Discussionmentioning

confidence: 99%

Bipolar versus Monopolar Transurethral Resection of the Prostate: Results of a Comparative, Prospective Bicenter Study – Perioperative Outcome and Long-Term Efficacy

Neyer¹,

Reissigl²,

Schwab³

et al. 2012

Urol Int

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Objectives: To compare bipolar and monopolar transurethral resection of the prostate (TURP) in a comparative prospective study at two urology centers. Methods: Of 212 patients with symptomatic benign prostatic hyperplasia entered prospectively into the study, 111 underwent bipolar and 101 monopolar TURP. Patients were treated in two consecutive series with each surgical method at both centers. Improvement in peak flow rate, postvoid residual, International Prostate Symptom Score, and quality of life score postoperatively and at 3, 12, 24 and 36 months, as well as long-term adverse events were compared. Regarding safety, duration of surgery, postoperative catheterization and hospitalization time, amount of fluid absorption, frequency of transurethral resection (TUR) syndrome, and risk of hemorrhage were evaluated. Results: Patient characteristics of the two series were comparable. The risk of developing TUR syndrome (p = 0.32) and bleeding tendency (p = 0.52) did not differ significantly between groups. Significant differences were seen for duration of surgery and resection speed. All functional parameters improved significantly during follow- up, with no relevant differences between surgical groups. Conclusions: Since no major differences in efficacy and safety were seen between the surgical groups, we feel that the monopolar technique still has a valuable place in TURP.

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Section: Discussionmentioning

confidence: 99%

Bipolar versus Monopolar Transurethral Resection of the Prostate: Results of a Comparative, Prospective Bicenter Study – Perioperative Outcome and Long-Term Efficacy

Neyer¹,

Reissigl²,

Schwab³

et al. 2012

Urol Int

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“…Recent experimental laboratory investigations showed a lower bleeding rate and deeper coagulation capacity with the bipolar armamentarium [ 10,11 ] . This could lead to a lower blood loss, fewer transfusions and a reduced risk of clot retention in the clinical setting.…”

Section: T U E B a N D T R A N S U R E T H R A L R E S E C T I O N I mentioning

confidence: 99%

Comparison of transurethral enucleation with bipolar and transurethral resection in saline for managing benign prostatic hyperplasia

et al. 2012

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Study Type – Therapy (case series)Level of Evidence 4What's known on the subject? and What does the study add?Transurethral enucleation with bipolar (TUEB) has been widely adopted as an alternative to standard TURP, although the surgical technique, efficacy and safety of TUEB have not been described so far.The present study provides illustrations of the TUEB technique, as well as peri‐operative, 6‐month and 12‐month follow‐up results of TUEB from a retrospective review of a single‐institution experience comparing the efficacy and safety of TUEB and transurethral resection in saline for managing BPH.OBJECTIVE To illustrate the transurethral enucleation with bipolar (TUEB) technique and compare the efficacy and safety of TUEB and transurethral resection in saline (TURis) for managing benign prostatic hyperplasia (BPH). PATIENTS AND METHODS A retrospective review of a single‐institution experience of 110 consecutive TUEB or TURis between 2008 and 2011 at our hospital was performed aiming to compare the efficacy and safety of TUEB and TURis for managing BPH (55 patients in each group). Peri‐operative data included operating time, resected tissue weight, changes in haemoglobin, duration of catheterization, hospital stay and early complications. Postoperative outcomes included 6‐ and 12‐month postoperative International Prostate Symptom Score (IPSS), and Quality of Life (QoL) score, uroflowmetry findings, change in serum prostate‐specific antigen level and all late complications in the two groups. RESULTS Both groups were well matched for age, preoperative prostate volume, IPSS, QoL and uroflowmetry findings. The change in haemoglobin at postoperative day 1 in the TUEB group was significantly less than in the TURis group (1.08 vs 1.60 g/dL; P < 0.001). Catheterization time and hospital stay were significantly shorter in the TUEB group than in the TURis group and the mean retrieved tissue weight in the TUEB group was larger than that in the TURis group (41.3 vs 31.7 g; P= 0.007). Patients in the two arms had comparable improvements in postoperative IPSS, QoL, maximum flow rate and postvoid residual urine volume. The rates of complications were equally low with each procedure. CONCLUSION TUEB is superior to TURis, with less bleeding, as well as decreased catheter time and hospital stay, although showing equivalent efficacy at 12 months of follow‐up.

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“…Wendt-Nordahl et al [11] also confirmed that the bleeding rate was lower in the Vista system (another bipolar resection device, ACMI Corporation, USA) with increasing output power (at level 7 and level 8) than monopolar TURP. Wendt-Nordahl et al [12] still reported that compared with conventional monopolar resection, bleeding was significantly reduced when tissue ablation was performed with the bipolar resectoscope (another one developed by Karl Storz, Germany). But the coagulation zones were found to be smaller [11] and marginally deeper although not statistically significant [12] ex vivo.…”

Section: Resultsmentioning

confidence: 99%

“…Wendt-Nordahl et al [12] still reported that compared with conventional monopolar resection, bleeding was significantly reduced when tissue ablation was performed with the bipolar resectoscope (another one developed by Karl Storz, Germany). But the coagulation zones were found to be smaller [11] and marginally deeper although not statistically significant [12] ex vivo. Here, the results comparing the depths of the coagulation zones with bipolar resection and monopolar TURP were divergent.…”

Section: Resultsmentioning

confidence: 99%

The Hemostatic Properties of Transurethral Plasmakinetic Resection of the Prostate: Comparison with Conventional Resectoscope in an ex vivo Study

Wang

Huang

et al. 2008

Urol Int

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Aim: To compare the hemostatic properties of transurethral plasmakinetic resection of the prostate (PKRP) and standard transurethral resection of the prostate (TURP) ex vivo, as perioperative bleeding is still regarded as one of the major complications of transurethral prostatectomy. Materials and Methods: Isolated normal saline (NS)-perfused porcine kidneys were used to determine the hemostatic efficacy of PKRP and TURP. The perfusion fluid loss was semiquantitatively measured in relation to tissue ablation for the two techniques and specimens were evaluated histologically. Results: The PKRP group had a significantly smaller loss of NS than the TURP group (4.16 ± 1.25 and 6.39 ± 1.05 g/min, respectively, p < 0.01). Compared with the measurements with TURP, the depths of the coagulation zones with PKRP were significantly larger (225.09 ± 35.77 and 146.84 ± 18.91 µm, respectively, p< 0.01). Conclusions: PKRP ex vivo was associated with significantly better hemostasis than TURP.

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New Bipolar Resection Device for Transurethral Resection of the Prostate: Firstex-Vivoandin-VivoEvaluation

Cited by 48 publications

References 20 publications

Bipolar versus Monopolar Transurethral Resection of the Prostate: Results of a Comparative, Prospective Bicenter Study – Perioperative Outcome and Long-Term Efficacy

Bipolar versus Monopolar Transurethral Resection of the Prostate: Results of a Comparative, Prospective Bicenter Study – Perioperative Outcome and Long-Term Efficacy

Comparison of transurethral enucleation with bipolar and transurethral resection in saline for managing benign prostatic hyperplasia

The Hemostatic Properties of Transurethral Plasmakinetic Resection of the Prostate: Comparison with Conventional Resectoscope in an ex vivo Study

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