Different ablative treatments are in clinical use to lower perioperative morbidity and to maintain efficacy of transurethral resection of the prostate. Modifications to electrodes or high frequency units, or both, as well as improvements in laser technology have been tried. Transurethral resection is performed with a modified high frequency generator. The technique of 'coagulating intermittent cutting' allows reduction in morbidity and maintains the advantages of classical transurethral resection.

We explain the basic physics of transurethral resection of the prostate (TURP). Modifications of electrodes or high-frequency units that should improve TURP are discussed. Finally, we introduce Coagulating Intermittent Cutting (CIC), which is a TURP using a modified high-frequency generator. Results of in vitro experiments and the first data from a multicenter trial are demonstrated.

In spite of the high and lasting efficiency of transurethral prostatectomy, intraoperative blood loss results in increased morbidity in this procedure. This led to the development of many alternative treatment modalities in the last years. To minimize the risk of bleeding, we improved the high-frequency technology in several steps. To achieve this, the output signals of commercially available high-frequency generators were modulated to the effect that each cut results in an efficient coagulation zone in the tissue at excellent cutting quality. Laboratory and in vitro studies using porcine kidneys as well as clinical trials showed good cutting characteristics accompanied by a significant reduction of bleeding. As a result, blood transfusions were less necessary, the transurethral catheter could be removed earlier in the postoperative period, and hospitalization time was significantly reduced. In conclusion, the improved high-frequency technology in form of the "coagulating intermittent cutting" results in a blood-sparing tissue resection with a consecutive reduction of morbidity.

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