Bipolar electrosurgery for benign prostatic hyperplasia: transurethral electrovaporization and resection of the prostate

Smith, Daron; Khoubehi, Bijan; Patel, Anup

doi:10.1097/01.mou.0000160623.13366.e8

Cited by 39 publications

(18 citation statements)

References 14 publications

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“…There are 2 available designs on the market: braided-tip (Plasma-Cut) for finer fibrous tissue and spring-tip (Plasma-Cise™) for more dense fibrous tissue removal. The main difference between the PlasmaKinetic and cold knife urethrotomies is not only incision of the fibrous tissue but also evaporation, so that the recurrence of fibrotic tissue can be decreased [11,12,13,14]. In our study, the mean recurrence rate of the cold knife group (30%) was statistically higher than the PlasmaKinetic group (14%) at the end of 9th month (p < 0.05).…”

Section: Discussionmentioning

confidence: 56%

PlasmaKinetic™ versus Cold Knife Internal Urethrotomy in Terms of Recurrence Rates: A Prospective Randomized Study

Çeçen

Karadağ²,

Demir³

et al. 2014

Urol Int

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Objective: To evaluate the efficacy and outcomes of PlasmaKinetic™ urethrotomy against cold knife direct vision internal urethrotomy in terms of recurrence rates. Patients and Methods: A total of 136 male patients with urethral strictures were enrolled into the study. The patients were allocated to cold knife or PlasmaKinetic urethrotomy groups sequentially by using computer-generated numbers. Group A (PlasmaKinetic) and group B (cold knife) included 70 and 66 patients, respectively. All patients were reevaluated at the 3rd, 9th and 18th month postoperatively with uroflowmetry. Results: Group A patients had a postoperative 3rd-month maximum flow rate value of 16.09 ml/s, whereas this same parameter was 15.15 ml/s in group B (p < 0.05). The urethral stricture recurrence rate up to the 9-month period was statistically significant for group A (14%) compared with group B (30%). When we compared the recurrence rates of these groups from postoperative day 1 up to the 18th month, the results were 37% for group A and 33% for group B (p > 0.05). Conclusion: PlasmaKinetic urethrotomy provides a better recurrence-free rate during the early period compared with conventional cold knife therapy. Nevertheless, the outcome of the stricture did not change and fibrotic tissue reformed between the 9th and the 18th month.

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Section: Discussionmentioning

confidence: 56%

PlasmaKinetic™ versus Cold Knife Internal Urethrotomy in Terms of Recurrence Rates: A Prospective Randomized Study

Çeçen

Karadağ²,

Demir³

et al. 2014

Urol Int

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“…Bipolar devices have both the active and return poles incorporated into the electrode, or in the electrode and the resectoscope [Smith et al 2005]. The method has a much shorter tissue penetration, of about 50-100 mm, generating less collateral thermal damage and less tissue charring [Thiel and Petrou, 2009].…”

Section: Initial Transurethral Vaporization (Tuvp) Technique and Resultsmentioning

confidence: 99%

Bipolar vaporization of the prostate: is it ready for the primetime?

Bucuras¹,

Bardan²

2011

Therapeutic Advances in Urology

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Although transurethral resection of the prostate is still the 'gold standard' in the surgical management of benign prostatic hyperplasia, it is associated with significant morbidity. This review presents one of its most successful alternatives, bipolar transurethral vaporization of the prostate, a procedure that has emerged during the last decade. The technical principles are presented, together with the trials that compare it with the standard resection technique. The review concludes that bipolar vaporization of the prostate is safe and effective, providing very good hemostasis control and low complication rates, at a significantly reduced cost per procedure. Improved vision and hemostasis make it suitable for patients with cardiac pacemakers, bleeding disorders, or those under anticoagulant therapy. However, long-term followup and more randomized trials are still needed, to validate the value of bipolar vaporization.

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“…Bu elektriksel rezistansın yarattığı ısı 400 °C'ye kadar çıkabilir (6). B-TURP da ise radyofrekans enerjisi iletken ortamda elektrotun etrafında enerji yüklü partiküller içeren bir buhar (plazma) tabakası oluşturur ve bu da doku içerisindeki organik bağları çözer ve doku ayrışmasını gerçekleştirir (7). Bu hızlı buharlaşmaya ve prostat dokusunun kolayca kesilmesine yol açar.…”

Section: Monopolar Ve Bipolar Teknolojileri Ve Teknik Farklılıklarıunclassified

“…Aktif elektrottan çıkan akım dokulardan geçmeden yanındaki dönüş elektrotuna geçer ve bu da diatermi pedi kullanım gereksinimini ortadan kaldırır (7). Bipolar sistemlerde 80-100 V'da koagülasyon gerçekleşirken monopolar sistemlerde bu voltaj 500-800 V'da çıkabilir (7). Bu nedenle bipolar prostat elektrocerrahinin doku etkileri monopolar elektrocerrahideki 300-400 °C ile karşılaştırıldığında çok daha düşük sıcaklıklarda gerçekleşir (40-70 °C) (7).…”

Section: Monopolar Ve Bipolar Teknolojileri Ve Teknik Farklılıklarıunclassified

Monopolar and Bipolar Modalities of Transurethral Prostate Resection

Köseoğlu¹,

Akman²

2015

uob

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Benign prostat hiperplazisine (BPH) bağlı alt üriner sistem semptomları (AÜSS) yaşlanan erkekte en sık rastlanan hastalıklardandır. Gerek medikal gerek cerrahi tedavi seçenekleri son 20 yılda büyük bir gelişim göstermiştir. Cerrahi tedavide 30-80 ml hacmindeki prostatlar için transüretral prostat rezeksiyonu (TUR-P) halen altın standarttır. Günümüzde halen yaygın uygulanmakta olan klasik monopolar TUR-P yanında bipolar TUR-P sistemler de giderek artan oranlarda uygulanmaktadır. Yakın zamanlı meta-analiz sonuçları klinik etkinlik açısından bipolar ve monopolar sistemler arasında fark saptamamakta ve kanama, pıhtı retansiyonu açısından bipolar avantajını öne çıkartmaktadır. Çok merkezli, yüksek hasta sayılı ve farklı bipolar sistemlerin cerrah faktörünün de kontrol edilebildiği prospektif çalışma sonuçlarını elde edinceye kadar mevcut pratikte monopolar veya bipolar sistemler ile tedavi gerekli hastalarda tedaviye devam edilmesi uygun olacaktır. Anahtar Kelimeler: Prostat, transüretral, rezeksiyon, monopolar, bipolar Benign prostate hyperplasia (BPH) related lower urinary tract symptoms (LUTS) is among the most common diseases in the aging male. Both medical and surgical treatment modalities have been improved strikingly in the last 20 years. Transurethral resection of the prostate (TUR-P) is still the gold standard for the surgical treatment for the prostates with the volume of 30-80 ml. Today, besides monopolar classical TUR-P systems which are still widely used, bipolar TUR-P systems are also being used in the increasing numbers. Results of recent meta-analyses did not determine difference between monopolar and bipolar systems in terms of clinical efficacy, in addition, showed bipolar advantages in terms of bleeding and clot retention. Both monopolar and bipolar systems shall better be used until the results of multi-centered prospective studies which compare both modalities with high number of patients together with controlling surgeon factors. Keywords: Prostate, transurethral, resection, monopolar, bipolar Summary ÖzDerleme / Review

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Bipolar electrosurgery for benign prostatic hyperplasia: transurethral electrovaporization and resection of the prostate

Cited by 39 publications

References 14 publications

PlasmaKinetic™ versus Cold Knife Internal Urethrotomy in Terms of Recurrence Rates: A Prospective Randomized Study

PlasmaKinetic™ versus Cold Knife Internal Urethrotomy in Terms of Recurrence Rates: A Prospective Randomized Study

Bipolar vaporization of the prostate: is it ready for the primetime?

Monopolar and Bipolar Modalities of Transurethral Prostate Resection

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