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A Prospective, Randomized Trial Comparing Conventional Transurethral Prostate Resection With PlasmaKinetic® Vaporization of the Prostate: Physiological Changes, Early Complications and Long-Term Followup

2006; Lippincott Williams & Wilkins; Volume: 176; Issue: 1 Linguagem: Inglês

10.1016/s0022-5347(06)00492-7

1527-3792

Nicola H.Y. Hon, David Brathwaite, Z. Hussain, S. Ghiblawi, H. Brace, Dickon Hayne, S.W.V. Coppinger,

Prostate Cancer Diagnosis and Treatment

No AccessJournal of UrologyAdult urology1 Jul 2006A Prospective, Randomized Trial Comparing Conventional Transurethral Prostate Resection With PlasmaKinetic® Vaporization of the Prostate: Physiological Changes, Early Complications and Long-Term Followup N.H.Y. Hon, D. Brathwaite, Z. Hussain, S. Ghiblawi, H. Brace, D. Hayne, and S.W.V. Coppinger N.H.Y. HonN.H.Y. Hon , D. BrathwaiteD. Brathwaite , Z. HussainZ. Hussain , S. GhiblawiS. Ghiblawi , H. BraceH. Brace , D. HayneD. Hayne , and S.W.V. CoppingerS.W.V. Coppinger View All Author Informationhttps://doi.org/10.1016/S0022-5347(06)00492-7AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We compared standard transurethral prostate resection with bipolar PlasmaKinetic® prostate vaporization for bladder outflow obstruction using a Gyrus® PlasmaKinetic® Plasma V™ bar. Materials and Methods: A total of 160 men were enrolled in a prospective, randomized trial. Those at higher risk for cancer were excluded by prostate specific antigen and digital rectal examination with or without transrectal ultrasound biopsy. A total of 81 men underwent prostate vaporization and 79 underwent transurethral prostate resection. Preoperative International Prostate Symptom Score and quality of life score, uroflowmetry, post-void residual urine and transrectal ultrasound prostate volume were recorded. Preoperative and postoperative serum hemoglobin, hematocrit and sodium were measured. Perioperative fluid absorption was calculated using weighing on table and blood loss using the Hemocue® system. Longer followup of International Prostate Symptom Score and quality of life score, uroflowmetry and post-void residual urine was available in 149 men, including 76 who underwent prostate vaporization and 73 who underwent transurethral prostate resection. Data were analyzed using the 1 or 2-sample t and chi-square tests. Results: The 2 groups were comparable in all preoperative parameters. Perioperative fluid absorption, intraoperative blood loss, preoperative and postoperative serum hematocrit, and sodium changes were not statistically different. Mean resection time was 4 minutes shorter for transurethral prostate resection (28.5 vs 32.6 minutes, p = 0.08). Patients with transurethral prostate resection showed a greater hemoglobin decrease (1.39 vs 0.8 gm/dl, p = 0.002) and required more irrigation postoperatively (28.3 vs 20.4 l, p = 0.001). Four patients with transurethral prostate resection required transfusion compared with none who underwent prostate vaporization. After transurethral prostate resection hospital stay was longer (3.36 vs 3.02 days, p = 0.03). Cancer was detected in 8 patients with transurethral prostate resection (10%), of whom 7 are under prostate specific antigen surveillance and 1 received radical radiotherapy. Mean long-term followup was 258 days (range 82 to 884). Prostate vaporization and transurethral prostate resection were equally effective at followup, as evidenced by changes in maximum urine flow, International Prostate Symptom Score, quality of life score and post-void residual urine. Conclusions: The 2 operations are highly effective in experienced hands. PlasmaKinetic® prostate vaporization resulted in less postoperative bleeding and a slightly shorter hospital stay. The lack of a histological specimen with this version of PlasmaKinetic® prostate vaporization may mean that clinically significant cancers are missed. References 1 : Symptoms of the transurethral resection syndrome using glycine as the irrigant. J Urol1995; 154: 123. Link, Google Scholar 2 : Operative factors and the long term incidence of myocardial infarction after transurethral resection of the prostate. Epidemiology1996; 7: 93. 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Volume 176Issue 1July 2006Page: 205-209 Advertisement Copyright & Permissions© 2006 by American Urological AssociationKeywordsvolatilizationtransurethral resection of prostatebladder neck obstructionprostateMetricsAuthor Information N.H.Y. Hon More articles by this author D. Brathwaite More articles by this author Z. Hussain More articles by this author S. Ghiblawi More articles by this author H. Brace More articles by this author D. Hayne More articles by this author S.W.V. Coppinger More articles by this author Expand All Advertisement PDF downloadLoading ...