Bipolar plasma vaporization using plasma-cutting and plasma-loop electrodes versus cold-knife transurethral incision for the treatment of posterior urethral stricture: a prospective, randomized study

OBJECTIVE: Evaluate the efficiency and safety of bipolar plasma vaporization using plasma-cutting and plasma-loop electrodes for the treatment of posterior urethral stricture. Compare the outcomes following bipolar plasma vaporization with conventional cold-knife urethrotomy. METHODS: A randomized trial was performed to compare patient outcomes from the bipolar and cold-knife groups. All patients were assessed at 6 and 12 months postoperatively via urethrography and uroflowmetry. At the end of the first postoperative year, ureteroscopy was performed to evaluate the efficacy of the procedure. The mean follow-up time was 13.9 months (range: 12 to 21 months). If re-stenosis was not identified by both urethrography and ureteroscopy, the procedure was considered “successful”. RESULTS: Fifty-three male patients with posterior urethral strictures were selected and randomly divided into two groups: bipolar group (n=27) or cold-knife group (n=26). Patients in the bipolar group experienced a shorter operative time compared to the cold-knife group (23.45±7.64 hours vs 33.45±5.45 hours, respectively). The 12-month postoperative Qmax was faster in the bipolar group than in the cold-knife group (15.54±2.78 ml/sec vs 18.25±2.12 ml/sec, respectively). In the bipolar group, the recurrence-free rate was 81.5% at a mean follow-up time of 13.9 months. In the cold-knife group, the recurrence-free rate was 53.8%. CONCLUSIONS: The application of bipolar plasma-cutting and plasma-loop electrodes for the management of urethral stricture disease is a safe and reliable method that minimizes the morbidity of urethral stricture resection. The advantages include a lower recurrence rate and shorter operative time compared to the cold-knife technique.

Eeffect of transurethral bipolar and resection bicyclol Plasma cutting on treatment of high-risk BPH / 中国基层医药

Objective To explore the high-risk patients with benign prostatic hypeiplasia using bipolar transurethral resection of prostate for the treatment of dual-loop electrosurgical excision of the safety .effectiveness.Methods To retrospectively analyze of 56 cases with high-risk BPH patients with United States bicyclol CIRCON ion bipolar TURP TURP mirror line.Results Operation time was 50～100 minutes,an average of 70 minutes.1 case of mild postoperative incontinence,1PSS score from(28.2 ±1.5)to(7.0 ±1.0).voiding patency,fewer complications.Conclusion 1.Lavage using normal saline to avoid TURS syndrome,operative time can be extended accordingly.2.The current through the body,suitable for patients with special diseases.3.Reducing the incidence of capsularperforation.4.Less bleeding and reduce the occurrence of postoperative complications.5.TURP plasma removal of prostate tissue without charring,suitable for histopathological examination,to avoid the TURP and TUVP undetected pathological examination,increased prostate cancer detection rate.