PlasmaKinetic Superpulse Transurethral Resection versus Conventional Transurethral Resection of Prostate

Patankar, Suresh; Jamkar, Arun; Dobhada, Satyen; Gorde, Vaibhav

doi:10.1089/end.2006.20.215

Cited by 67 publications

(52 citation statements)

References 17 publications

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“…Michielsen et al have reported significantly longer operating times with bipolar resection (12). Recent studies have shown shorter operating times, less blood loss and shorter periods of irrigation and catheterization with bipolar resection (13,14). Improvement in Qmax in our study was significantly higher with the bipolar group although IPSS was comparable in both the groups.…”

Section: Commentscontrasting

confidence: 52%

Transurethral resection of prostate: a comparison of standard monopolar versus bipolar saline resection

et al. 2010

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Introduction: Transurethral resection syndrome is an uncommon but potentially life threatening complication. Various irrigating solutions have been used, normal saline being the most physiological. The recent availability of bipolar cautery has permitted the use of normal saline irrigation. Material and Methods: In a randomized prospective study, we compared the safety and efficacy of bipolar cautery (using 0.9% normal saline irrigation) versus conventional monopolar cautery (using 1.5% glycine irrigation). Pre and postoperative hemoglobin (Hb) and hematocrit values were compared. Hemodynamics and arterial oxygen saturation were monitored throughout the study. Safety end points were changes in serum electrolytes, osmolarity and Hb/PCV (packed cell volume). Efficacy parameters were the International Prostate Symptom Score (IPSS) and Qmax (maximum flow rate in mL/sec) values. Results: Mean preoperative prostate size on ultrasound was 60 ± 20cc. Mean resected weight was 17.6 ± 10.8 g (glycine) and 18.66 ± 12.1 g (saline). Mean resection time was 56.76 ± 14.51 min (glycine) and 55.1 ± 13.3 min (saline). The monopolar glycine group showed a greater decline in serum sodium and osmolarity (4.12 meq/L and 5.14 mosmol/L) compared to the bipolar saline group (1.25 meq/L and 0.43 mosmol/L). However, this was not considered statistically significant. The monopolar glycine group showed a statistically significant decline in Hb and PCV (0.97 gm %, 2.83, p < 0.005) as compared to the bipolar saline group (0.55 gm % and 1.62, p < 0.05). Patient follow-up (1,3,6 and 12 months postoperatively) demonstrated an improvement in IPSS and Qmax in both the groups. Conclusion: We concluded that bipolar transurethral resection of prostate is clinically comparable to monopolar transurethral resection of prostate with an improved safety profile. However, larger number of patients with longer follow up is essential.

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Section: Commentscontrasting

confidence: 52%

Transurethral resection of prostate: a comparison of standard monopolar versus bipolar saline resection

et al. 2010

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“…However, they reported no advantages of P-TURP in terms of intra-and post-operative bleeding, the duration of hospitalization, operation time and late complications. Patankar et al [8] emphasized that P-TURP enabled faster tissue resection in a bloodless area and a safer surgery using saline irrigation. Bhansali et al [9] stated that P-TURP could be used safely and effectively for the resection of a large gland (>60 g) based on a minimum of 9 months follow-up data.…”

Section: Discussionmentioning

confidence: 99%

Comparative outcomes of plasmakinetic versus monopolar transurethral resection of benign prostatic hyperplasia: 7 years' results

Erturhan

Bayrak

Şeçkiner

et al. 2013

Turkish Journal of Urology

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Objective: We compared results from the standard monopolar or the bipolar plasmakinetic method for the transurethral resection of the prostate (TURP) due to benign prostatic hyperplasia (BPH) at 4 and 7 years after surgery (medium to long term). Material and methods:A retrospective analysis was performed on the complete data from 124 patients who were alive and had 7 years of regular follow-up. Of those 124 patients with BPH, 65 (52%) underwent monopolar TURP (M-TURP) and 59 (48%) underwent plasmakinetic TURP (P-TURP). During the followup period, the International Prostate Symptom Score (IPSS), the maximal flow rate (Qmax) measured using uroflowmetry and the prostate specific antigen (PSA) values were recorded. Patients in whom alpha blockers were administered due to the growth of postoperative adenoma and who had been operated on due to urethral stricture, bladder neck contracture or a growing adenoma were also noted and recorded.Results: There was no statistically significant difference between M-TURP and P-TURP groups in any pre-operative or post-operative follow-up parameter at 4 or 7 years post-surgery. Specifically, PSA, IPSS and Qmax values; urethrotomies performed; alpha-blocker use; and the frequency of re-operations were statistically insignificant (p>0.05). Conclusion:Our study demonstrated that when medium-to long-term results are compared, P-TURP and M-TURP appear to result in similar IPSS scores, Qmax values, complication rates and retreatment rates. Larger prospective studies are required to corroborate these results.

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“…Bipolar group showed mean post-op Q-max 18.6 mL/sec, P value > 0.05 which is not statistically significant. Patankar et al (11) in his study had comparable improvement in Q-max in both groups (19.16 and 20.67 mL/sec) postoperatively. However, late followup of all our patients are required to evaluate a long-term outcome of both our surgical groups.…”

Section: Discussionmentioning

confidence: 65%

“…However, none of the patient in either group required blood transfusion. Patankar et al (11) in his study found significant blood loss among patients undergoing monopolar TURP (282.67 mL) as compared to those undergoing bipolar TURP (140.6 mL). Singhania et al (7) in his study showed statistically significant haemoglobin drop (0.97 gm%, p value < 0.005) as compared to bipolar group which showed small drop in haemoglobin (0.55 gm%, p value = 0.014).…”

Section: Discussionmentioning

confidence: 90%

Bipolar Versus Monopolar Transurethral Resection of Prostate - A Prospective Randomised Study

Jain¹,

Garg²,

Singla³

2016

jemds

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BACKGROUNDTransurethral resection of the prostate has been considered the gold surgical intervention for the patients with BPH. (1,2) Electrosurgery devices that have traditionally been used during TURP procedures have monopolar design and cannot be used with electrolyte containing irrigation fluid. In recent years, the use of bipolar TURP have challenged conventional monopolar TURP.Aim of this prospective randomised study is to compare the safety and efficacy of bipolar electrosurgical unit using saline as an irrigant with conventional monopolar electrosurgical unit using glycine as an irrigant. MATERIALS AND METHODSA total of 50 patients who underwent monopolar TURP (Group A: 25 patients) or Bipolar TURP (Group B: 25 patients) were analysed in Dept. of Surgery, Muzaffarnagar Medical College and Hospital from May 2015 to January 2016. Variables analysed were haemoglobin drop, serum sodium, serum potassium, IPSS, Q-max, QoL intraoperative resection time, amount of irrigant, resection volume were recorded. Post-operative haemoglobin, Na + , K + were assessed within 6 hours of surgery. Patients were followed after 6 weeks to assess the IPSS, Q-max and Qol. RESULTSThe mean age at presentation, prostate size, mean haemoglobin level and mean serum sodium, potassium level were comparable pre-operatively between both the groups. The mean resection time and resected weight in monopolar TURP was 56.24 mins. and 22.68 gm, while in bipolar TURP was 59.2 mins. and 21.09 gm respectively, which were not statistically significant. The amount of irrigant used for both groups was comparable. The monopolar group showed a statistically significant decline in haemoglobin (1.25 g%, p < 0.0001) as compared to the bipolar group (0.64 g%, p < 0.01). However, none of the patient required blood transfusion. Patients were followed after 6 weeks, both the groups showed comparable improvement in IPSS, Q-max, QoL. CONCLUSION BACKGROUNDBenign Prostatic Hyperplasia (BPH) is a highly prevalent condition in the adult male with more than 50% of the males over 60 years having histologically proven prostatic hyperplasia and at least half reporting moderate-to-severe Lower Urinary Tract Symptoms (LUTS). (1) Transurethral resection of the prostate has been considered the gold surgical intervention for the patients with BPH. (2) The development of TURP and the technical modification led to improved haemostasis and outcome with reduced transfusion rates and low perioperative mortality rates. (3)

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PlasmaKinetic Superpulse Transurethral Resection versus Conventional Transurethral Resection of Prostate

Cited by 67 publications

References 17 publications

Transurethral resection of prostate: a comparison of standard monopolar versus bipolar saline resection

Transurethral resection of prostate: a comparison of standard monopolar versus bipolar saline resection

Comparative outcomes of plasmakinetic versus monopolar transurethral resection of benign prostatic hyperplasia: 7 years' results

Bipolar Versus Monopolar Transurethral Resection of Prostate - A Prospective Randomised Study

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