Bipolar plasma vaporization of prostate for symptomatic large benign prostatic enlargement: two-year clinical results


Authors: W. S. Chan;  C. Kan
Published in: Urol List 2013; 11(1): 55-59

Overview

Big benign prostate enlargement (BPE) has always been a difficult condition to treat for urologists. Although transurethral resection of prostate (TURP) is the gold standard for BPE, even TURP is known to associate with high complication rate. We explore the use of bipolar transurethral electrovaporization of prostate (bipolar TUEVP) to tackle this surgical problem and reported our 2-year follow up results. We found good peri-operative results with favorable blood loss and hospital stay results, as well as clinical impro­vement over the voiding status of the patients in the first year. However, the clinical effect wore off after 2-year’s follow up. We conclude that bipolar TUEVP mono-therapy, should be indicated for selected patients who require a safe surgery to earn a relatively short period of relief from bladder outlet obstruction due to a big prostate.

Key words:
benign prostatic enlargement, bipolar, transurethral, electrovaporization


Sources

1. Mebust WK, Holtgrewe HL, Cokett AT et al. Trans­urethral prostatectomy: immediate and post-operative complications. A co-operative study of 13 participa­ting institutions evaluating 3885 patients. J Urol 1989; 141(2): 243–247.

2. Uchida T, Ohori M, Soh S et al. Factors influencing morbidity in patients undergoing transurethral resection of the prostate. Urology 1999; 53(1): 98–105.

3. Reich O, Gratzke C, Bachmann A et al. Morbidity, mortality and early outcome of transurethral resection of the prostate: a prospective multicenter evaluation of 10,654 patients. J Urol 2008; 180(1): 246–249.

4. Oelke M, Alivizatos G, Emberton M et al. Guidelines on benign prostatic hyperplasia. In Parsons KF, Irani J, Chapple CR et al (eds). European Association of Uro­logy Pocket Guidelines, Arnhem: Europena Associa­tion of Urology 2009: 90–97.

5. Varkarakis I, Kyriakakis Z, Delis A et al. Long-term results of open transvesical prostatectomy from a contemporary series of patients. Urology 2004; 64(2): 306–310.

6. Helfand B, Mouli S, Dedhia R et al. Management of lower urinary tract symptoms secondary to benign prostatic hyperplasia with open prostatectomy: results of a contemporary series. J Urol 2006; 176(6): 2557–2561.

7. Tubaro A, Carter S, Hind A et al. A prospective study of the safety and efficacy of suprapubic transvesical prostatectomy in patients with benign prostatic hyperplasia. J Urol 2001; 166(1): 172–176.

8. Serretta V, Morgia G, Fondacaro L et al. Open prostatectomy for benign prostatic enlargement in southern Europe in late 19902: a contemporary series of 1800 interventions. Urology 2002; 60(4): 623–627.

9. Gratzke C, Schlenker B, Seitz M et al. Complica­tions and early postoperative outcome after open prostatectomy in patients with benign prostatic enlargement: results of a prospective multicenter study. J Urol 2007; 177(4): 1419–1422.

10. Narayan P, Tewari A, Garzotto M et al. Trans­urethral vaportrode electrovaporization of the pros­tate: physical principles, technique, and results. Urology 1996; 47(4): 505–510.

11. Kaplan S, Te A et al. Transurethral electrovaporization of the prostate: a novel method for treating men with benign prostatic hyperplasia. Urology 1995; 45(4): 566–572.

12. Kaplan S, Te A. A comparative study of trans­urethral resection of the prostate using a modified electro-vaporizing loop and transurethral laser vapo­rization of the prostate. J Urol 1995; 154(5): 1785–1790.

13. Poulakis V, Dahm P, Witzsch U et al. Transurethral electrovaporization vs transurethral resection for symptomatic prostatic obstruction: a meta-analysis. BJU Int 2004; 94(1): 89–95.

14. Fagerstrom T, Nyman C, Hahn R et al. Bipolar transurethral resection of the prostate causes less bleeding than the monopolar technique: a single-centre randomized trial of 202 patients. BJU Int 2010; 105(11): 1560–1564.

15. Michielsen D, Debacker T, De Boe V et al. Bipolar transurethral resection in saline—an alternative surgical treatment for bladder outlet obstruction. J Urol 2007; 178: 2035–2039.

16. Geavlete B, Multescu R, Dragutescu M et al. Transurethral resection (TUR) in saline plasma vaporization of the prostate vs standard TUR of the prosate: ‘the better choice’ in benign prostatic hyperplasia? BJU Int 2010; 106(11): 1695–1699.

17. Noguera R, Rodriguez R. Open adenomectomy: past, present and future. Curr Opin Urol 2008; 18(1): 34–40.

18. Geavlete B, Georgescu D, Multescu R et al. Bipo­lar plasma vaporization vs monopolar and bipolar TURP – a prospective, randomized, long-term compa­rison. Urology 2011; 78(4): 930–935.

19. Ishikawa N, Goya N, Iguchi Y et al. Comparison of the depth of the desiccated zone with selected vapo­rizing-cutting electrodes: a basic study in animals. BUJ Int 2000; 85(6): 754–758.

20. Thomas K, Cornaby A, Hammadeh M et al. Trans­urethral vaporization of the prostate: a promising new technique. Br J Urol 1997; 79(2): 186–189.

21. Deasutel M, Burney T, Diaz P et al. Outcome of vaportrode transurethral vaporization of the prostate using pressure-low urodynamic criteria. Urology 1998; 51(6): 1013–1017.

Labels
Paediatric urologist Urology

Article was published in

Urological Journal

Issue 1

2013 Issue 1

Most read in this issue

This topic is also in:


Login
Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account