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Evaluation of short term outcomes of patients undergone transurethral resection with plasmakinetic energy for benign prostate hyperplasia

Year 2013, Volume: 38 Issue: 4, 696 - 705, 01.12.2013

Abstract

Aim: To evaluate short term outcomes of patients undergone transurethral resection with plasmakinetic energy for benign prostate hyperplasia and to present safety and efficacy of the procedure. Material and Method:86 patients applied to our clinic between March 2011 and February 2012 were enrolled into the study. PSS scores, uroflowmetry, post voiding residual urine, prostate volumes of the patients were recorded. Post operative urethral stricture, bladder neck stricture, incontinance rates were noted. Data assessed after six months were compared to peroperative data. After the operations, the surgeons evaluated their comfort of surgery with visual analog scale from 0 to 10. Results: 24 of 86 patients were hospitalized for acute urinary retention. One patient was hospitalized because of hematuria. Peroperative IPSS was 22.2. at post operative sixth month, mean IPSS was 6.8. VAS scores of surgeons was; to assess visual comfort was 7.41, to assess coagulation was 7.62. Conclusion:After evaluating the data and literature, we believe bipolar plasmakinetik TUR is a safe and comforting method to treat bladder outlet obstruction with goog hemodynamic stability.

References

  • Fong YK, Milani S and Djavan B. Natural history and clinical predictors of clinical progression in benign prostatic hyperplasia Current Opinion Urology. 2005; 15:35-38
  • Glynn RJ, Campion EW, Bouchard GR, Silbert JE. The development of benign prostatic hyperplasia among volunteers in the normative aging study. Am J Epidemiol. 1985; 121:78-90
  • Neal DE. Transurethral prostatectomy. Br J Surg. 1994; 81:484-5.
  • Tkocz M, Prajsner A. Comparison of long-term results of transurethral incision of prostate with transurethral resection of the prostate, in patients with benign prostatic hypertrophy. Neurourol Urodyn. 2002; 21:112-6.
  • Yang Q,Peters TJ, Donovan JL, Wilt TJ, Abrams P. Transurethral incision compared with transurethral resection of the prostat efor bladder outlet obstruction: a systematic review and meta-analysis of randomised controlled trials. J Urol. 2001; 165:152632
  • Madersbacher S, Marberger M. Is transurethral resection of the prostate still justified? BJU Int. 1999; 83:227-37
  • Wasson JH, Reda DJ, Bruskewitz RC et al. A comparison of transurethral surgery with watchful waiting for moderate symptoms of benign prostatic hyperplasia. The Veterans Affairs Cooperative Study Group on Transurethral Resection of the Prostate. New Engl J Med. 1995; 332:75-9.
  • Morgan GE , Mikhail MS, Murray MJ, Larson CP. Anesthesia for genitourinary surgery. Morgan E, Mikhail MS, Murray JM, Larson C, eds. Clinical Anestesiology, 3.ed. USA: McGraw-Hill Companies. 2002; 36:692-707.
  • Kayhan Z. Boşaltım Sistemi ve Anestezi. Klinik Anestezi. 2. Baskı. İstanbul : Logos Yayıncılık. 1997; 27:340-54
  • Gravenstein D. Transurethral resection of the prostate (TURP) syndrome: A review of the pathophysiology and management. Anesth Analg. 1997; 84:438-46.
  • Mebust WK, Holtgrewe HL, Cockett AT. Transurethral prostatectomy-immediate and postoperative complications: A operative study 13 participating institutions evaluating 3885 patients. J Urol. 1989; 141:243-7.
  • Jensen V. The TURP syndrome. Can J Anaesth. 1991; 38:90-6.
  • Borboroglu PG ,Kane CJ, Ward JF, Roberts JL, Sands JP. Immediate and postoperative complications of transurethral prostatectomy in the 1990s. J Urol. 1999;162:1307-10.
  • Concato J, Horwitz RI, Feinstein AR, Elmore JG, Schiff SF. Problems of comorbidity in mortality after prostatectomy. JAMA. 1992; 267:1077-82.
  • Roos NP, Wennberg JE, Malenka DJ. Mortality and reoperation after open and transurethral resection of the protate for benign prostatic hyperplasia. N Enl J Med. 1989; 320:1120-4.
  • Hammadeh MY, Madaan S, Singh M, Philp T. A 3year follow-up of a prospective randomized trial comparing transurethral electrovaporization of the prostate with Standard transurethral prostatectomy. BJU Int. 2000; 86:648-51.
  • Loh SY, Chin CM. A demographic profile of patients undergoing transurethral resection of the prostat efor benign prostate hyperplasia and presenting in acute urinary retention. BJU Int. 2002; 89:531-3.
  • Boyle P,Robertson C, Vaughan ED, Fitzpatrick JM. A meta-analysis of trials of transurethral needle ablation for treating symptomatic benign prostatic hyperplasia. BJU Int. 2004; 94:83-8.
  • Erturhan S, Erbagci A, Seckiner I, Yagci F, Ustun A. Plasmakinetic resection of the prostate versus Standard transurethral resection of the prostate: a prospective randomized trial with 1-year follow-up. Prostate cancer prostatic dis. 2007; 10:97-100.
  • Singh H, Desai MR, Shrivastav P, Vani K. Bipolar versus monopolar trnsurethral resection of prostate:randomized controlled study. J Endourol. 2005; 19:333-8.
  • Dincel Ci Samli MM, Guler C, Demirbas M, Karalar M. Plasmakinetic vaporization of the prostate: clinical evaluation of a new technique. J Endourol. 2004; 18:293-8.
  • Dawkins GP, Miller RA: Sorbitol-mannitol solution for Urological electrosurgical resection: A safer fluid than glycine 1.5%. Eur Urol. 1999; 36: 99-102.
  • Ho HS, Yip SK,Lim KB, Fook S, Foo KT, Cheng VW. A prospective randomized study comparing monopolar and bipolar transurethral resection of prostate using transurethral resection in saline (TURIS) system. Eur Urol. 2007; 52:517-22.
  • Nuhoglu B, Ayyildiz A, Karaguzel E, Cebeci O, Germiyanoglu C. Plasmakinetic prostate resection in the treatment of benign prostate hyperplasia: results of 1-year follow up. Int J Urol. 2006; 13:21–4. de Sio M, Autorino R, Quarto G, et al. Gyrus bipolar versus Standard monopolar transurethral resection of the prostate: a randomized prospective trial. Urology. 2006; 67:69–72.
  • Bhansali M, Patankar S, Dobhada S, Khaladkar S. Management of large (>60 g) prostate gland: PlasmaKinetic Superpulse (bipolar) versus conventional (monopolar) transurethral resection of the prostate. J Endourol. 2009; 23:141–6.
  • Fung BT, Li SK,Yu CF, Lau BE, Hou SS. Prospective randomized controlled trial comparing plasmakinetic vaporesection and conventional transurethral resection of the prostate. Asian J Surg. 2005; 28:24-28.
  • Helke C, Manseck A, Hakenberg OW, Wirth MP. Is transurethral vaporesection of the prostate beter than standart transurethral resection? Eur Urol. 2001; 39:551-7.
  • Tefekli A, Muslumanoglu AY, Baykal M, Binbay M, Tas A, Altunrende F. A hybrid technique using bipolar energy in transurethral prostate surgery: a prospective, randomized comparison. J Urol. 2005; 174:1339–43.
  • Hammarsten J, Lidqvist K, Sunzel H. Urethral stricture following transurethral resection of the prostate. The role of the catheter. Br J Urol. 1989; 63:397-400.
  • Hart AJ , Fowler JW. Incidence of urethral stricture after transurethral resection of prostate. Effects of urinary infection, urethral flora and catheter material and size. Urology. 1981; 18:558-91.
  • Michielsen DP, Debacker T, De Boe V, et al. Bipolar transurethral resection in saline-an alternative surgical treatment for bladder outlet obstruction? J Urol. 2007; 178:2035–9.
  • Eaton AC, Frncis RN: The provision of transurethral prostatectomy on a day-case basis using bipolar plasma kinetic technology. BJU Int. 2002; 89: 534-7.
  • Yazışma Adresi / Address for Correspondence: Dr. Nevzat Can Şener Sağlık Bakanlığı Adana Numune E ğİtim ve Araştırma Hastanesi, Üroloji Kliniği Yüreğir/ADANA Tel: +90 505 3328474 geliş tarihi/received :20.04.2013 kabul tarihi/accepted:21.05.2013

Plazmakinetik Enerji Teknolojisi Kullanılarak Transüretral Prostat Rezeksiyonu Yapılan benign Prostat Hiperplazi Hastalarının Kısa Dönem Sonuçlarının Değerlendirilmesi

Year 2013, Volume: 38 Issue: 4, 696 - 705, 01.12.2013

Abstract

Amaç: Bu çalışmamızda Plasma Kinetik Doku Tedavi Sistemi ile transüretral rezeksiyon (TURP) yapılan, semptomatik benign prostat hiperplazili (BPH) hastaların kısa dönem sonuçlarını inceleyerek, Plasma Kinetik Doku Tedavi Sisteminin etkinlik ve yan etki profilini ortaya koymaya çalıştık. Materyal ve Metod: Mart 2011 ile şubat 2012 tarihleri arasında kliniğimize başvuran benin prostat hiperplazi (BPH) tanısı ile ameliyat kararı alınan 86 hasta çalışma kapsamına alındı. Hastaların; IPPS semptom skorlaması, üroflowmetri, artık idrar miktarı tayini, prostat hacimleri, belirlendi. Tüm hastaların ameliyat sonrası üretra darlığı, mesane boyun darlığı, inkontinans gibi erken ve geç istenmeyen yan etkileri kaydedildi. Hastalar ameliyat süreleri, ameliyat sırasında kullanılan irrigasyon sıvısı miktarı ve transfüzyon gerekliliği, ameliyat sonrası hastanede kalış ve katerizasyon süreleri, irrigasyon sıvısı miktarları kaydedildi. 6.ayda hastalardan elde edilen veriler ameliyat öncesi verilerle kıyaslandı. Ameliyatı gerçekleştiren doktorlara görüntü kalitesinin 0"dan 10"a doğru artış gösterdiği söylendikten sonra, skala üzerinde kişisel derecelendirme yapmaları istendi. Bulgular: Çalışmaya dahil edilen 86 hastadan 24"ünün başvuru nedeni akut üriner retansiyona bağlı olarak gelişen glob vezikale idi. Bir hastada yatış endikasyonu hematüri nedeniyle olmuştu. Çalışmaya alınan hastaların operasyon öncesi IPSS değerlerinin genel ortalaması 22,2 idi. Postoperatif 6.aydaki sorgulamalarında ortalama IPSS değeri 6,8 olarak tespit edilmiştir. Operasyondan hemen sonra, rezektoskopun çıkarılmasını takiben, cerrahın cerrahi alan görüntü kalitesini ölçmeyi hedefleyen VAS skoru ortalaması 7,41, cihazın kanama kontrolü yeteneğini ölçmeyi hedefleyen VAS skoru ortalaması 7,62 bulunmuştur. Sonuç: Çalışmamızda ortaya çıkan sonuçlar ve literatür verileri kılavuzluğunda; bipolar TURP teknolojisinin, mesane çıkım obstrüksiyonuna yol açmış benign prostat hiperplazisinin endoskopik cerrahi tedavisinde daha iyi hemodinamik stabilite ve cerrahi işlem sırasında daha yüksek konfor sağlaması nedeniyle monopolar TURP uygulamalarına iyi bir alternatif olduğu kanısına vardık.

References

  • Fong YK, Milani S and Djavan B. Natural history and clinical predictors of clinical progression in benign prostatic hyperplasia Current Opinion Urology. 2005; 15:35-38
  • Glynn RJ, Campion EW, Bouchard GR, Silbert JE. The development of benign prostatic hyperplasia among volunteers in the normative aging study. Am J Epidemiol. 1985; 121:78-90
  • Neal DE. Transurethral prostatectomy. Br J Surg. 1994; 81:484-5.
  • Tkocz M, Prajsner A. Comparison of long-term results of transurethral incision of prostate with transurethral resection of the prostate, in patients with benign prostatic hypertrophy. Neurourol Urodyn. 2002; 21:112-6.
  • Yang Q,Peters TJ, Donovan JL, Wilt TJ, Abrams P. Transurethral incision compared with transurethral resection of the prostat efor bladder outlet obstruction: a systematic review and meta-analysis of randomised controlled trials. J Urol. 2001; 165:152632
  • Madersbacher S, Marberger M. Is transurethral resection of the prostate still justified? BJU Int. 1999; 83:227-37
  • Wasson JH, Reda DJ, Bruskewitz RC et al. A comparison of transurethral surgery with watchful waiting for moderate symptoms of benign prostatic hyperplasia. The Veterans Affairs Cooperative Study Group on Transurethral Resection of the Prostate. New Engl J Med. 1995; 332:75-9.
  • Morgan GE , Mikhail MS, Murray MJ, Larson CP. Anesthesia for genitourinary surgery. Morgan E, Mikhail MS, Murray JM, Larson C, eds. Clinical Anestesiology, 3.ed. USA: McGraw-Hill Companies. 2002; 36:692-707.
  • Kayhan Z. Boşaltım Sistemi ve Anestezi. Klinik Anestezi. 2. Baskı. İstanbul : Logos Yayıncılık. 1997; 27:340-54
  • Gravenstein D. Transurethral resection of the prostate (TURP) syndrome: A review of the pathophysiology and management. Anesth Analg. 1997; 84:438-46.
  • Mebust WK, Holtgrewe HL, Cockett AT. Transurethral prostatectomy-immediate and postoperative complications: A operative study 13 participating institutions evaluating 3885 patients. J Urol. 1989; 141:243-7.
  • Jensen V. The TURP syndrome. Can J Anaesth. 1991; 38:90-6.
  • Borboroglu PG ,Kane CJ, Ward JF, Roberts JL, Sands JP. Immediate and postoperative complications of transurethral prostatectomy in the 1990s. J Urol. 1999;162:1307-10.
  • Concato J, Horwitz RI, Feinstein AR, Elmore JG, Schiff SF. Problems of comorbidity in mortality after prostatectomy. JAMA. 1992; 267:1077-82.
  • Roos NP, Wennberg JE, Malenka DJ. Mortality and reoperation after open and transurethral resection of the protate for benign prostatic hyperplasia. N Enl J Med. 1989; 320:1120-4.
  • Hammadeh MY, Madaan S, Singh M, Philp T. A 3year follow-up of a prospective randomized trial comparing transurethral electrovaporization of the prostate with Standard transurethral prostatectomy. BJU Int. 2000; 86:648-51.
  • Loh SY, Chin CM. A demographic profile of patients undergoing transurethral resection of the prostat efor benign prostate hyperplasia and presenting in acute urinary retention. BJU Int. 2002; 89:531-3.
  • Boyle P,Robertson C, Vaughan ED, Fitzpatrick JM. A meta-analysis of trials of transurethral needle ablation for treating symptomatic benign prostatic hyperplasia. BJU Int. 2004; 94:83-8.
  • Erturhan S, Erbagci A, Seckiner I, Yagci F, Ustun A. Plasmakinetic resection of the prostate versus Standard transurethral resection of the prostate: a prospective randomized trial with 1-year follow-up. Prostate cancer prostatic dis. 2007; 10:97-100.
  • Singh H, Desai MR, Shrivastav P, Vani K. Bipolar versus monopolar trnsurethral resection of prostate:randomized controlled study. J Endourol. 2005; 19:333-8.
  • Dincel Ci Samli MM, Guler C, Demirbas M, Karalar M. Plasmakinetic vaporization of the prostate: clinical evaluation of a new technique. J Endourol. 2004; 18:293-8.
  • Dawkins GP, Miller RA: Sorbitol-mannitol solution for Urological electrosurgical resection: A safer fluid than glycine 1.5%. Eur Urol. 1999; 36: 99-102.
  • Ho HS, Yip SK,Lim KB, Fook S, Foo KT, Cheng VW. A prospective randomized study comparing monopolar and bipolar transurethral resection of prostate using transurethral resection in saline (TURIS) system. Eur Urol. 2007; 52:517-22.
  • Nuhoglu B, Ayyildiz A, Karaguzel E, Cebeci O, Germiyanoglu C. Plasmakinetic prostate resection in the treatment of benign prostate hyperplasia: results of 1-year follow up. Int J Urol. 2006; 13:21–4. de Sio M, Autorino R, Quarto G, et al. Gyrus bipolar versus Standard monopolar transurethral resection of the prostate: a randomized prospective trial. Urology. 2006; 67:69–72.
  • Bhansali M, Patankar S, Dobhada S, Khaladkar S. Management of large (>60 g) prostate gland: PlasmaKinetic Superpulse (bipolar) versus conventional (monopolar) transurethral resection of the prostate. J Endourol. 2009; 23:141–6.
  • Fung BT, Li SK,Yu CF, Lau BE, Hou SS. Prospective randomized controlled trial comparing plasmakinetic vaporesection and conventional transurethral resection of the prostate. Asian J Surg. 2005; 28:24-28.
  • Helke C, Manseck A, Hakenberg OW, Wirth MP. Is transurethral vaporesection of the prostate beter than standart transurethral resection? Eur Urol. 2001; 39:551-7.
  • Tefekli A, Muslumanoglu AY, Baykal M, Binbay M, Tas A, Altunrende F. A hybrid technique using bipolar energy in transurethral prostate surgery: a prospective, randomized comparison. J Urol. 2005; 174:1339–43.
  • Hammarsten J, Lidqvist K, Sunzel H. Urethral stricture following transurethral resection of the prostate. The role of the catheter. Br J Urol. 1989; 63:397-400.
  • Hart AJ , Fowler JW. Incidence of urethral stricture after transurethral resection of prostate. Effects of urinary infection, urethral flora and catheter material and size. Urology. 1981; 18:558-91.
  • Michielsen DP, Debacker T, De Boe V, et al. Bipolar transurethral resection in saline-an alternative surgical treatment for bladder outlet obstruction? J Urol. 2007; 178:2035–9.
  • Eaton AC, Frncis RN: The provision of transurethral prostatectomy on a day-case basis using bipolar plasma kinetic technology. BJU Int. 2002; 89: 534-7.
  • Yazışma Adresi / Address for Correspondence: Dr. Nevzat Can Şener Sağlık Bakanlığı Adana Numune E ğİtim ve Araştırma Hastanesi, Üroloji Kliniği Yüreğir/ADANA Tel: +90 505 3328474 geliş tarihi/received :20.04.2013 kabul tarihi/accepted:21.05.2013
There are 33 citations in total.

Details

Primary Language Turkish
Journal Section Research
Authors

Süleyman Barış Kartal This is me

Hakan Erçil This is me

Faruk Kuyucu This is me

Ediz Vuruşkan This is me

Nevzat Can Şener This is me

Adem Altunkol This is me

Zafer Gökhan Gürbüz This is me

Publication Date December 1, 2013
Published in Issue Year 2013 Volume: 38 Issue: 4

Cite

MLA Kartal, Süleyman Barış et al. “Plazmakinetik Enerji Teknolojisi Kullanılarak Transüretral Prostat Rezeksiyonu Yapılan Benign Prostat Hiperplazi Hastalarının Kısa Dönem Sonuçlarının Değerlendirilmesi”. Cukurova Medical Journal, vol. 38, no. 4, 2013, pp. 696-05.