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Bipolar plasma vaporization versus monopolar TUR and "cold-knife" TUI in secondary bladder neck sclerosis - an evidence based, retrospective critical comparison in a single center clinical setting.
| Content Provider | Europe PMC |
|---|---|
| Author | Moldoveanu, C Geavlete, B Jecu, M Stanescu, F Adou, L Bulai, C Ene, C Geavlete, P |
| Copyright Year | 2014 |
| Abstract | Introduction: A long term, retrospective study was performed aiming to outline a critical comparison concerning the efficacy, safety and durability of the bipolar plasma vaporization (BPV), standard monopolar transurethral resection (TUR) and “cold-knife" “star" transurethral incision (TUI) in secondary bladder neck sclerosis (BNS) cases. Materials & Methods: Of the 126 patients included in the trial based on maximum flow rate (Qmax) below 10 mL/s and International Prostate Symptom Score (IPSS) over 19, classical resection was performed in 46 cases, “cold-knife" TUI in 37 cases and bipolar vaporization in 43 patients. The evaluation protocol comprised IPSS, QoL (quality of life) score, Qmax and PVR (post-voiding residual urinary volume) assessment performed at 1, 3, 6, 12, 18 and 24 months after the initial intervention. Results: Significant intraoperative complications (capsular perforation – 8.7%; bleeding – 4.3%) occurred secondary to monopolar resection. “Star" TUI was the fastest technique, followed by plasma-button vaporization (7.2 and 11.4 versus 16.5 minutes). BPV and TUI patients benefitted from the shortest catheterization periods (0.75 and 1 versus 2.0 days) and hospital stays (1.0 and 1.25 versus 2.0 days). Immediate postoperative adverse events consisted of hematuria (6.5% of the TUR cases) and acute urinary retention (8.1% of the TUI group). Significantly higher long term BNS recurrence rates requiring re-treatment were established in the TUI (18.7%) and TUR (12.8%) series by comparison to BPV (5.4%). Among patients that completed the follow-up protocol, equivalent IPSS, QoL, Qmax and PVR features were determined in the 3 study arms. Conclusions: The plasma vaporization approach was confirmed as a successful match to conventional TUR and “cold-knife" TUI in terms of surgical safety profile, postoperative recovery, therapeutic durability and urodynamic and symptom score parameters. |
| ISSN | 1844122X |
| Journal | Journal of Medicine and Life |
| Volume Number | 7 |
| PubMed Central reference number | PMC3956105 |
| Issue Number | 1 |
| PubMed reference number | 24653766 |
| e-ISSN | 18443117 |
| Language | English |
| Publisher | Carol Davila University Press |
| Publisher Date | 2014-03-25 |
| Publisher Place | Romania |
| Access Restriction | Open |
| Rights License | This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use,distribution, and reproduction in any medium, provided the original work is properly cited. ©Carol Davila University Press |
| Subject Keyword | bipolar plasma vaporization monopolar transurethral resection “cold-knife" transurethral incision secondary bladder neck sclerosis |
| Content Type | Text |
| Resource Type | Article |
| Subject | Neuroscience Public Health, Environmental and Occupational Health Medicine Neurology (clinical) |
