Gyrus Plasmasect: Is It Better than Monopolar Transurethral Resection of Prostate?

Abstract

Introduction: This randomized prospective study was conducted to compare the efficacy and safety of the Gyrus Plasmasect loop bipolar transurethral resection of prostate (TURP) and conventional monopolar TURP in the treatment of benign prostatic hyperplasia (BPH). Materials and Methods: A total of 117 men were enrolled in this study. Fifty-eight patients underwent Gyrus Plasmasect TURP and 59 patients underwent monopolar TURP. They were followed up for 3 months after surgery. Results: Significant improvements were seen postoperatively in both the Gyrus and monopolar groups in terms of prostatic volume, International Prostate Symptom Score, quality of life score, peak flow rate, and post-void residual urine volume. However, the degree of improvement was not statistically different between the 2 groups. Significantly less blood loss, shorter postoperative catheterization time and length of hospital stay were seen in the Gyrus group. Conclusions: Gyrus Plasmasect TURP yielded comparable results to monopolar TURP; however, this is only a preliminary study and follow-up is necessary to assess its long-term efficacy.

Bipolar versus monopolar TURP: a prospective controlled study at two urology centers

“…1,2,10-13 Differing results have been reported for intraoperative blood loss. Yang et al 9 found a significant advantage with the bipolar method, but no significant difference for bleeding tendency was shown in recent studies or in our patients. 10,23 An increased risk of stricture after bipolar resection 20,21 was not confirmed by our findings, which is in accordance with other authors.…”

“…1,9,10,14 The differences between the two groups with regard to IPSS and Q-max-as the most important subjective and objective measures of the outcome of surgery-were not statistically significant. There were also no significant differences for QoL scores related to micturition.…”

“…By 2007, the median number of years of experience in urology was 10 years (range [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. Patients in both study arms were treated by the same surgeons.…”

“…The absence of reverse current is intended to decrease the risk of burns and subsequent stricture formation. 8,9 Studies already published have described advantages of bipolar resection with regard to the frequency of the TUR syndrome, 1,2,10-13 intraoperative absorption of fluid, risk of hemorrhage, 14 duration of postoperative indwelling catheter irrigation, duration of catheterization and duration of hospitalization. 2,9,11,15 The duration of surgery, improvement in Q-max, residual urine volume, IPSS and QoL score have, however, been reported as similar to the monopolar approach.…”

2010 Update: Guidelines for the management of benign prostatic hyperplasia

“…Recent reports suggest bipolar resection is associated with a reduction in the risk of dilutional hyponatremia (TUR syndrome), improvements in intraoperative visibility and may result in shorter catheterization times. [54][55][56][57] Laser prostatectomy Holmium laser enucleation (HoLEP) can be used effectively in larger glands and in patients on anticoagulation with reported reduced hospitalization, bleeding and duration of catheterization. Results both early and long-term are similar to TURP, confirming this modality is a suitable first-line surgical option among urologists skilled with the technique.…”