Thick vs thin loop transurethral resection of the prostate: a double‐blind prospective trial of early morbidity

Holmes, Michael; Cox, Jane; Stewart, James E.; King, DannieH.; Bary, P. R.; Wright, Wendy L.

doi:10.1046/j.1464-4096.2001.02412.x

Cited by 14 publications

(11 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Improved hemostasis obtained with the thick loop allowed us to reduce the time of continuous bladder irrigation, which was interrupted 12-24 h instead of 36-48 h after the procedure; this is a signifi cant improvement regarding direct patient care by nursing staff. In accordance with other authors [9][10][11] we did not fi nd any signifi cant statistical improvement of electrolyte balance or hematocrit in the thick loop group with respect to the standard loop group after surgery. There were no differences in long-term complications between two groups, which is to be expected as such events are intrinsically linked to the principles of transurethral surgery and are not related to the higher current adopted for the thick loop [12] .…”

Section: Discussionsupporting

confidence: 92%

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

D’Addessi¹,

Porreca²,

Foschi³

et al. 2005

Urol Int

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionsupporting

confidence: 92%

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

D’Addessi¹,

Porreca²,

Foschi³

et al. 2005

Urol Int

View full text Add to dashboard Cite

show abstract

“…0.0001). These fi ndings were interesting when compared with those of a double-blind, prospective trial comparing thick-vs. thin-loop transurethral resection [11] , where the p values for duration of catheterization and length of the hospital stay were 0.91 and 0.14, respectively. Correspondingly, Gallucci et al [12] , in a multicentric, randomized clinical study comparing TUVRP with the TURP procedure, reported for these same two parameters signifi cant interprocedural differences (both p !…”

Section: Discussionmentioning

confidence: 99%

Transurethral Electrovapor Resection versus Standard Transurethral Resection Treatment for a Large Prostate: A 2-Year Follow-Up Study Conducted in Taiwan

Liu

Lee

et al. 2006

Urol Int

View full text Add to dashboard Cite

Introduction: Those patients featuring a large prostate and undergoing transurethral resection typically face a longer duration of surgery, they have a higher degree of hemorrhage and a higher irrigant volume required for the procedure, and they tend to reflect a higher incidence of morbidity than is the case for a small prostate. We report on the relative safety and efficacy of transurethral electrovapor resection of the prostate (TUVRP) as compared with standard transurethral resection of the prostate (TURP) for Taiwanese patients having a prostate size >50 ml. Patients and Methods: Seventy-six symptomatic benign prostatic hyperplasia patients featuring a prostate size >50 ml were randomized and underwent either TUVRP using wedge loop or standard TURP. Perioperative parameters, treatment outcome, and adverse events associated with the surgical procedure are assessed herein. Results: Mean operation time, changes in hemoglobin levels, resected prostate weight, perioperative irrigant volume needed, and incidences of recatheterizations and readmissions, all differed significantly when the two surgical procedures were compared. The average expense differences for the two procedures were impressive (p < 0.0001). No postoperative intergroup sexual dysfunction differences were noted. Clinical improvements following either TUVRP or TURP were significant and sustained for at least a period of 2 years. Intergroup comparison of International Prostate Symptom Score, quality of life, peak flow rate, and postvoid residual volume revealed no significant differences at 2 years (p = 0.45, 0.48, 0.12, and 0.29, respectively). The need for postoperative medical retreatment and/or reoperation did not differ significantly between the two groups (p = 0.62 and p = 0.56, respectively, at 6 months and p = 0.47 and p = 0.48, respectively, at 2 years). Conclusions: The TUVRP procedure offers advantages as regards a number of perioperative parameters when compared with the TURP procedure, and it seems that TUVRP might provide at least an equivalent treatment outcome as is the case for TURP.

show abstract

“…Abb. 1), um über einen län ge ren Ge we be kon takt einen ef fi zi en teren Ko agu la ti ons ef fekt beim Re sek ti onsvor gang zu schaf fen [7,11].…”

Section: Va Ria Ti On Der Re Sek Ti Ons Sch Lin Genunclassified

“…Einen mög li cher wei se bes se ren Ko agu la ti ons ef fekt durch eine brei te re Kon takt flä che zum Ge we be er kauft man sich mit ei ner deut lich hö he ren Ap pli kati on von Ener gie (130-180 W ver sus 230-250 W), was wie de rum zu ei ner ver mehrten ther mi schen Ge we be schä di gung und neu ro mus ku lä ren Sti mu la ti on führt [7,11]. Ein ho her Strom fluss in der Api kal re gi on der Pros ta ta er höht das Ri si ko ei ner Schä-di gung des Sphink ter ex ter nus und damit ei ner kon se ku ti ven Stress har nin kon tinenz [6,18,23].…”

Section: Wel Che An Sät Ze Konn Ten Sich Durch Set Zen?unclassified

“…Abb. 1), um über einen län ge ren Ge we be kon takt einen ef fi zi en teren Ko agu la ti ons ef fekt beim Re sek ti onsvor gang zu schaf fen [7,11].Eine Son der form stellt hier der Ro tore sect dar. An stel le ei ner Schlin ge n elektro de wird eine axi al ver schieb ba re, ak tiv ro tie ren de Fräs kop f elek tro de ein ge setzt, um das Ge we be me cha nisch ab zu tra gen. Durch Ap pli ka ti on von Hoch fre quenzstrom er folgt si mul tan ein Va po ri sa ti onsund Ko agu la ti ons ef fekt [15,16,17].…”

unclassified

See 1 more Smart Citation

Transurethrale Resektion bei benigner Prostatahyperplasie

Alschibaja

Treiber

et al. 2005

Urologe [A]

View full text Add to dashboard Cite

Transurethral resection of the prostate still represents the "gold standard" in surgical treatment of symptomatic benign prostatic enlargement (BPE). New demands were made on transurethral electrosurgery with the appearance of alternative, minimal invasive procedures. Bleeding complications had to be reduced. Different attempts were made to improve the conventional TURP. Band loops and roller bars were developed in order to gain a more effective coagulation during the cutting process by a larger tissue contact. Major advances could be achieved by modifications of the high-frequency generator. Improved procedures like the "Coagulating-Intermittent-Cutting" (CIC), the "Instant-Response-", as well as the "Dry-Cut-Technology" combine cutting and coagulating effects to realize lowered bleeding and an efficient resection process. The introduction of bipolar currency flow opens the possibility of conventional TUR-P with saline solutions and thus to the theoretical avoidance of the TUR-syndrome. By the neoadjuvant use of 5alpha-reductase-inhibitors before planned TUR-P, bleeding- and irrigation fluid absorption should be reduced by lowering perfusion and the size of the prostate. Regarding these innovative approaches which improve the surgical standard and minimize the risk of perioperative complications, transurethral electrosurgery remains the method of choice in instrumental therapy of symptomatic BPE. In the future efficacy and costs will be comparable to those of the transurethral laser-resection or laser-vaporisation.

show abstract

Thick vs thin loop transurethral resection of the prostate: a double‐blind prospective trial of early morbidity

Cited by 14 publications

References 16 publications

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

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

Transurethral Electrovapor Resection versus Standard Transurethral Resection Treatment for a Large Prostate: A 2-Year Follow-Up Study Conducted in Taiwan

Transurethrale Resektion bei benigner Prostatahyperplasie

Contact Info

Product

Resources

About