Thick Loop Prostatectomy in the Endoscopic Treatment of Benign Prostatic Hyperplasia: Results of a Prospective Randomised Study

Abstract

Objective: The thick loop is a new device employed for transurethral resection of the prostate (TURP) using the standard resectoscope. The loop is broader and thicker than the standard one, resulting in better hemostasis because of its ability to cut, coagulate and vaporize tissue simultaneously. We evaluated the safety and efficacy of the thick loop device compared with the standard loop. Patients and Methods: 103 patients with symptomatic benign prostatic hyperplasia were randomized to undergo either thick loop (51 patients) or standard loop TURP (52 patients). Patients were considered for surgery with the American Urological Association (AUA) symptom score greater than 7 and a maximum urinary flow rate <15 ml/s. Serum hemoglobin, hematocrit, electrolytes, operative time, prostate resected weight, catheterization time and complications were recorded. Twelve months later, the AUA score, maximum urinary flow rate (Q_max) and postvoiding residual urine volume were evaluated. Results: There were no significant differences between thick and standard loop TURP regarding the operative and catheterization time, prostate resection weight and postoperative levels of hemoglobin, hematocrit and electrolytes. Twelve months after TURP, the AUA score was significantly lower and Q_max greater in the thick loop compared to the standard loop groups. Conclusions: Thick loop TURP is as safe as standard loop TURP with respect to blood loss, operative time and complications. Operating in a virtually bloodless field could allow a more radical TURP and provide an explanation for the better functional results (Q_max and AUA score) obtained by the thick loop resection.

Ejaculation Sparing Bladder Neck Incision with Holmium Laser in Patients with Urinary Symptoms and Small Prostates: Short-Term Functional Results

“…Similarly, Wasson et al [16] reported a 5% reoperation rate in a 188,000 series of patients who underwent TURP during a 5-year follow-up period. Also when particular device in order to improve turp performance was used the impact of complication on sexual aspect is quite high [17].…”

Preoperative multiparametric prostate magnetic resonance imaging: a safe clinical practice to reduce incidental prostate cancer in Holmium laser enucleation of the prostate

“…Holmium laser enucleation of the prostate (HoLEP) demonstrated to be safe, efficient, time durable [4, 5], less invasive compared to open surgery and capable to be applied in all prostate sizes [6]. HoLEP permits to retrieval of adequate tissue, comparable to open surgery and transurethral resection of prostate (TURP) [7, 8], in order to detect an incidental prostate cancer (iPCa) [9, 10].…”