The Hemostatic Properties of Transurethral Plasmakinetic Resection of the Prostate: Comparison with Conventional Resectoscope in an ex vivo Study

Qu, Lijun; Wang, Xinghuan; Huang, Xing; Zhang, Yanqing; Zeng, Xianwei

doi:10.1159/000127344

Cited by 17 publications

(9 citation statements)

References 29 publications

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“…Such complications can be a significant cause of morbidity in patients undergoing TURP, as they might mean the need for re‐operation or blood transfusion. The reasons for the observed haemostatic advantages of B‐TURP are not entirely clear, although some trials have suggested that bipolar energy results in deeper coagulative effects .…”

Section: Discussionmentioning

confidence: 99%

Systematic review and meta‐analysis of the clinical effectiveness of bipolar compared with monopolar transurethral resection of the prostate (TURP)

et al. 2013

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• To compare monopolar and bipolar transurethral resection of the prostate (TURP) for clinical effectiveness and adverse events.• We conducted an electronic search of MEDLINE, Embase, CENTRAL, Science Citation Index, and also searched reference lists of articles and abstracts from conference proceedings for randomised controlled trials (RCTs) comparing monopolar and bipolar TURP.• Two reviewers independently undertook data extraction and assessed the risk of bias in the included trials using the tool recommended by the Cochrane Collaboration.• The quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.• From the 949 abstracts that were identified, 94 full texts were assessed for eligibility and a total of 24 trials were included in the review.• No statistically significant differences were found in terms of International Prostate Symptom Score (IPSS) or health-related quality of life (HRQL) score.• Results for maximum urinary flow rate were significant at 3, 6 and 12 months (all P < 0.001), but no clinically significant differences were found and the meta-analysis showed evidence of heterogeneity in the included trials; 22/24 trials had a short follow-up of ≤1 year, there was no evidence of a sample size calculation in 20/24 trials and the application of GRADE showed the evidence for most of the assessed outcomes to be of moderate quality, including all those in which statistical differences were found. • Whilst there is no overall difference between monopolar and bipolar TURP for clinical effectiveness, bipolar TURP is associated with fewer adverse events and therefore has a superior safety profile.• Various methodological limitations were highlighted in the included trials and as such the results of this review should be interpreted with caution. • There is a need for further well-conducted, multicentre RCTs with long-term follow-up data.

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Section: Discussionmentioning

confidence: 99%

Systematic review and meta‐analysis of the clinical effectiveness of bipolar compared with monopolar transurethral resection of the prostate (TURP)

et al. 2013

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“…As theoretical support, some ex vivo experiments have shown that a bipolar current has the nature of deep coagulation and a ''cut-and-seal'' property. [24][25][26] The authors indicated that these characteristics may contribute to a good hemostasis capacity of B-TURP.…”

Section: Discussionmentioning

confidence: 99%

In-Hospital Outcomes and Cost Assessment Between Bipolar Versus Monopolar Transurethral Resection of the Prostate

Sugihara

Yasunaga

Horiguchi

et al. 2012

Journal of Endourology

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Purpose: We compared the in-hospital outcomes between bipolar and monopolar transurethral resection of the prostate (B-TURP and M-TURP, respectively) on a real-world practice using a large database. Patients and Methods: Patients who underwent TURP were extracted from the Diagnosis Procedure Combination database, which is a case-mix administrative claims database in Japan. TURP procedures were classified into M-TURP and B-TURP groups according to intraoperative use or nonuse of D-sorbitol solution, respectively, which is the only nonelectrolyte bladder irrigation fluid for M-TURP available in Japan. To exclude causality among autologous and homologous transfusion events, we confined eligible hospitals to those in which no autologous blood preparation was undertaken for TURP and whose annual surgical caseloads were 15 cases or more. Multivariate analyses were conducted for homologous transfusion, postoperative complications, operative time, postoperative length of stay, and total costs. Results: There were 5155 M-TURP and 1531 B-TURP patients identified. The results for M-TURP vs B-TURP (effect sizes were evaluated with reference to M-TURP) were 2.3% vs 1.3% for transfusion (odds ratio [OR] = 0.54; P = 0.013), 3.3% vs 1.7% for postoperative complications (OR = 0.46; P < 0.01), 98 vs 116 minutes for operative time (20.5% increase; P < 0.001), 8.65 vs 8.45 days for postoperative stay (3.6% reduction; P = 0.003), and $6103 vs $6062 for cost (1.7% reduction; P = 0.018). Conclusion: B-TURP had significantly lower rates of transfusion and postoperative complications, but a longer operative time. The impacts of B-TURP on shortening the hospital stay and lowering the costs were of little clinical significance.

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“…Recently, several ex vivo studies have confirmed the superior capability of bipolar current to achieve better haemostasis through deeper coagulation and through the so called ‘cut-and-seal’ effect of plasma produced by bipolar current [13], [14], [15].…”

Section: Discussionmentioning

confidence: 98%

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

Elsakka

Eltatawy

Almekaty

et al. 2016

Arab Journal of Urology

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ObjectivesTo compare the safety and efficacy of bipolar transurethral plasma vaporisation (B-TUVP) as an alternative to the ‘gold standard’ monopolar transurethral resection of the prostate (M-TURP) for the treatment of benign prostatic hyperplasia (BPH) in a prospective randomised controlled study.Patients and methodsIn all, 82 patients indicated for prostatectomy were assigned to two groups, group I (40 patients) underwent B-TUVP and group II (42 patients) underwent M-TURP. The safety of both techniques was evaluated by reporting perioperative changes in serum Na+, serum K+, haematocrit (packed cell volume), and any perioperative complications. For the efficacy assessment, patients were evaluated subjectively by comparing the improvement in International Prostate Symptom Score and objectively by measuring the maximum urinary flow rate (Qmax) and post-void residual urine volume (PVR) before and after the procedures.ResultsIn group II, there was a significant perioperative drop in serum Na+ (from 137.5 to 129.4 mmol/L) and haematocrit (from 42.9% to 38.2%) (both P < 0.001). Moreover, one patient in group II had TUR syndrome. The remote postoperative complication rate was (15%) in group I and comprised of stress urinary incontinence (5%), bladder outlet obstruction (5%), and residual adenoma (5%). In group II, the remote postoperative complication rate was (4.8%), as two patients developed urethral stricture. There were statistically significant improvements in micturition variables postoperatively in both arms, but the magnitude of improvement was statistically more significant in group II.ConclusionB-TUPV seems to be safer than M-TURP; however, the lack of a tissue specimen and the relatively high retreatment rate are major disadvantages of the B-TUVP technique. Moreover, M-TURP appears to be more effective than B-TUPV and its safety can be improved by careful case selection and adequate haemostasis.

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The Hemostatic Properties of Transurethral Plasmakinetic Resection of the Prostate: Comparison with Conventional Resectoscope in an ex vivo Study

Cited by 17 publications

References 29 publications

Systematic review and meta‐analysis of the clinical effectiveness of bipolar compared with monopolar transurethral resection of the prostate (TURP)

Systematic review and meta‐analysis of the clinical effectiveness of bipolar compared with monopolar transurethral resection of the prostate (TURP)

In-Hospital Outcomes and Cost Assessment Between Bipolar Versus Monopolar Transurethral Resection of the Prostate

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

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