The provision of transurethral prostatectomy on a day‐case basis using bipolar plasma kinetic technology

Abstract

Objective To evaluate, in a prospective study, the potential for providing elective transurethral prostatectomy on a day‐case basis, using new bipolar electrosurgical technology. Patients and methods Forty men with confirmed bladder outlet obstruction caused by benign prostatic enlargement underwent plasma kinetic vaporization of the prostate (PKVP) in the Day Surgery Unit; they were scheduled to be discharged on the day of surgery with an indwelling catheter, returning for a trial removal of the catheter at 48 h, and followed up at 2 and 4 months after surgery. Results Thirty‐four (85%) of the 40 patients were able to return home on the day of surgery. All patients, including the six who failed to return home as a day‐case, successfully voided at 48 h; 78% felt the procedure was acceptable on a day‐case basis. At 4 months the mean improvement in the International Prostate Symptom Score and Quality of Life score were 64% and 84%, respectively. The mean improvement in flow rate was 200–250%. Conclusion PKVP effectively relieves prostatic obstruction, at least in the short‐term (a longer term follow‐up is required). The procedure can be delivered safely on a day‐case basis and was very acceptable to the patients.

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

“…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.…”

“…5,6 It consists of a 17 mm-long, goldplated, crescent-shaped cutting tool, with no major differences from the standard monopolar instruments. The diameter of the bipolar resection loop is, however, a little smaller than that of the conventional monopolar instrument.…”

A prospective, randomized clinical trial comparing bipolar plasma kinetic resection of the prostate versus conventional monopolar transurethral resection of the prostate in the treatment of benign prostatic hyperplasia

“…However, the procedure has complications, such as blood loss, that need blood transfusion (up to 8%) and transurethral resection (TUR) syndrome (up to 2%) 6. The sharp cutting action using plasmakinetic electrovaporization and resection using a loop electrode (as in the Gyrus system) should prevent these complications, improving homeostasis during the procedure and reducing the risk of hyponatremia (normal saline instead of glycine was used as the irrigation fluid) 610–13. The bipolar electrosurgical equipment simultaneously vaporizes tissue during resection, which controls bleeding as it effectively and accurately seals all bleeding points 8101415.…”

Comparative randomized study on the efficaciousness of endoscopic bipolar prostate resection versus monopolar resection technique. 3 year follow-up

“…The total re-intervention rate was 6%, including 2.4% who required reoperation for bladder neck contracture, 1.9% for recurrent BPH obstruction, and 1.7% for urethral stricture. The annual rate of reoperation after minimal TURP is 2.5% and the reoperation rate at 8 year follow-up is 23% after minimal resection and 7% after TURP (11).…”