A prospective randomised controlled study comparing bipolar plasma vaporisation of the prostate to monopolar transurethral resection of the prostate

Elsakka, Ahmed M.; Eltatawy, Hssan H.; Almekaty, Khaled; Ramadan, A. A.; Gameel, Tarik A; Farahat, Yasser

doi:10.1016/j.aju.2016.09.005

Cited by 18 publications

(9 citation statements)

References 25 publications

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“…1,2 Contemporary papers still report bleeding following surgery to be as high as 4.8% for monopolar TURP. 3 Interestingly, a Chinese group discovered an increasing rate of returns to theatre to control bleeding (from 0.4% to 2.7% over a 15-year period). 4 Transurethral resection syndrome is also a well recognised complication, some theorists noting an incidence of 1-2.4%.…”

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confidence: 99%

“…4 Transurethral resection syndrome is also a well recognised complication, some theorists noting an incidence of 1-2.4%. 1,3,5 Overall failure to void (which is likely to be secondary to detrusor failure) is reported to occur in 5.8-6.5% of cases. 1,2 Historically, procedural mortality has been quoted as 0.23% 2 but over the last two decades, large scale series have had mortality rates of 0-0.1%.…”

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confidence: 99%

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The changing practice of transurethral resection of the prostate

Elmussareh

Morrison

et al. 2018

annals

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Introduction Transurethral resection of the prostate (TURP) is considered the gold standard surgical treatment for lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia. The number of TURPs performed has declined significantly over the last three decades owing to pharmaceutical therapy. TURP data from a single institution for the years 1990, 2000 and 2010 were compared to assess the difference in performance. Methods A retrospective analysis was undertaken of all patients who underwent TURP between January and December 2010. These findings were compared with historical data for the years 1990 and 2000: 100 sets of case notes were selected randomly from each of these years. Results The number of TURPs performed fell from 326 in 1990 to 113 in 2010. The mean age of patients increased from 70.6 years to 74.0 years. There was also a significant increase in the mean ASA grade from 1.9 to 2.3. The most common indication for TURP shifted from LUTS to acute urinary retention. No significant change in operating time was observed. The mean resection weight remained constant (22.95g in 1990, 22.55g in 2000, 20.76g in 2010). A reduction in transfusion rates was observed but there were higher rates of secondary haematuria and bladder neck stenosis. There was an increase from 2% to 11.5% of patients with long-term failure to void following TURP. Conclusions The number of TURPs performed continues to decline, which could lead to potential training issues. Urinary retention is still by far the most common indication. However, there has been a significant rise in the percentage of men presenting for TURP with high pressure chronic retention. The number of patients with bladder dysfunction who either have persistent storage LUTS or eventually require long-term catheterisation or intermittent self-catheterisation has increased markedly, which raises the question of what the long-term real life impact of medical therapy is on men with LUTS secondary to benign prostatic hyperplasia who eventually require surgery.

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confidence: 99%

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confidence: 99%

The changing practice of transurethral resection of the prostate

Elmussareh

Morrison

et al. 2018

annals

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“…The incidence of bleeding after monopolar TURP requiring transfusion varies between 0.4 and 7.1% [10,14,24,25] versus zero transfusion during bipolar prostatic vaporization [25]. We did not note any bleeding complications requiring transfusion as shown in Table 1.…”

Section: Discussionmentioning

confidence: 69%

Transurethral Resection of the Prostate at the Urology Department of Ignace Deen Hospital, Conakry, Guinea

Barry¹,

Camara²,

Bah³

et al. 2021

IJCU

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Transurethral resection of the prostate (TURP) remains the gold standard treatment for benign prostatic hyperplasia (BPH). Objective: To report the results of TURP to the Urology Department of Ignace Deen National hospital Patients and methods: This was a prospective, descriptive study of 2 years 5 months (January 1, 2015 to May 31, 2017), carried out in the urology department of the Ignace Deen National Hospital. We included 86 patients who benefited from an isolated TURP or associated with another surgical procedure. Results: TURP accounted for 51.19% of endoscopic surgery and 20.18% of prostate surgery. The mean age was 69.21 years (48 and 89). The mean total PSA level was 17.7ng / ml. The mean prostate volume was 54, 22 cm 3 (27 and 107). The indication for surgery was dominated by chronic retention of bladder urine (93.02%). The mean duration of TURP was 41.84 min (28 and 58). Postoperative complications were dominated by orchi-epididymitis (5.81%) and UVR (4.66%). The mean length of stay was 5.63 days. The histologic types were: benign prostatic hyperplasia (69.77%), prostatic adenocarcinoma (29.07%) and high grade intraepithelial prostate neoplasia (1.16%). After a mean followup of 2.21 months, the result was good in 95.35% of cases. Conclusion: It offers low morbidity and a good result in almost all cases.

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“…A recent randomized control study comparing bipolar TUVP to monopolar TURP found that both were effective in reducing patient's IPSS (49.7% and 70.6% at 6 months' follow-up for TUVP and TURP, respectively) and improving peak flow rates, but with more statistically significant results in the TURP group 15 . Use of TUVP was also found to lead to a decreased duration of catheterization, improvements to postprocedure hematuria risk, decreased hematocrit drop, and fewer perioperative complications, but had higher rates of secondary intervention for clinical failure 16 …”

Section: Thermo-ablative Strategiesmentioning

confidence: 99%

Minimally invasive surgical therapies for benign prostatic hypertrophy: The rise in minimally invasive surgical therapies

Christidis

McGrath

Perera

et al. 2017

Prostate International

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The prevalence of benign prostatic hypertrophy (BPH) causing bothersome lower urinary tract symptoms increases with our ageing population. Treatment of BPH traditionally begins with medical therapy and surgical intervention is then considered for those whose symptoms progress despite treatment. Minimally invasive surgical therapies have been developed as an intermediary in the treatment of BPH with the aim of decreasing the invasiveness of interventions. These therapies also aim to reduce morbidity and dysfunction related to invasive surgical procedures.Multiple treatment options exist in this group including mechanical and thermo-ablative strategies. Emerging therapies utilizing differing technologies range from the established to the experimental. We review the current literature related to these minimally invasive therapies and the evidence of their effectiveness in treating BPH.The role of minimally invasive surgical therapies in the treatment of BPH is still yet to be strongly defined. Given the experimental nature of many of the modalities, further study is required prior to their recommendation as alternatives to invasive surgical therapy. More mature evidence is required for the analysis of durability of effect of these therapies to make robust conclusions of their effectiveness.

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A prospective randomised controlled study comparing bipolar plasma vaporisation of the prostate to monopolar transurethral resection of the prostate

Cited by 18 publications

References 25 publications

The changing practice of transurethral resection of the prostate

The changing practice of transurethral resection of the prostate

Transurethral Resection of the Prostate at the Urology Department of Ignace Deen Hospital, Conakry, Guinea

Minimally invasive surgical therapies for benign prostatic hypertrophy: The rise in minimally invasive surgical therapies

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