Comparison of Deep Biopsy Tissue Damage from Transurethral Resection of Bladder Tumors between Bipolar and Monopolar Devices

PURPOSE: Bipolar energy has recently been used for transurethral resection of bladder tumor (TURBT). Although this modality is thought to be safe, there are some controversies concerning the pathologic accuracy of the biopsy specimens. We compared clinical efficacy, safety, and pathologic characteristics of deep biopsy specimens between bipolar and monopolar devices. MATERIALS AND METHODS: From January 2002 to June 2007, a total of 115 patients underwent TURBT with deep biopsy with the use of bipolar (bipolar group, n=64) or monopolar (monopolar group, n=51) devices. We retrospectively analyzed tumor size, tumor number, urine cytology, perioperative blood loss (postoperative changes in hemoglobin levels), complications, duration of catheterization, duration of hospitalization, pathologic stage, WHO grade, deep biopsy specimen thickness, and grade of thermal damage. RESULTS: There were no statistical differences in tumor size, tumor number, urine cytology, complications, duration of hospitalization, pathologic stage, or WHO grade between the two groups. Postoperative changes in hemoglobin levels were significantly lower in the bipolar group (p=0.038), and the duration of catheterization was shorter in the bipolar group (p=0.026). The deep biopsy specimen thickness was significantly thinner in the bipolar group (2.25+/-0.94 mm vs. 3.02+/-1.39 mm, p<0.05). The grade of thermal damage was not statistically different between the two groups (p=0.862). CONCLUSIONS: In terms of clinical efficacy and safety, bipolar TURBT is comparable to monopolar TURBT, having advantages in perioperative blood loss and duration of catheterization. In addition, pathologic changes in deep biopsy after bipolar and monopolar TURBT are similar. Bipolar TURBT can be properly used for bladder tumors without pathologic error.

Factors Causing Acute Urinary Retention after Transurethral Resection of the Prostate in Patients with Benign Prostate Hyperplasia / 대한남성과학회지

PURPOSE: Urologists occasionally experience some cases of voiding failure after transurethral resection of prostate (TURP). Preoperative and postoperative factors attributable to acute urine retention (AUR) after catheter removal in post-TURP patients were evaluated and analyzed to determine the causative factors for AUR. MATERIALS AND METHODS: From June 2004 to May 2008, a total of 172 patients who underwent TURP due to symptomatic benign prostatic hyperplasia (BPH) were divided into the AUR group (n=21) and the control group (n=151). The AUR group was defined as patients with voiding difficulty within 24 hours and whose residual urine volume was above 400 ml after catheter removal. The control group was defined as patients without AUR. Age, duration of symptoms, International prostate symptom score (IPSS), Quality of life score (QoL), uroflowmetry, post-void residual urine volume, preoperative serum prostate specific antigen (PSA) level, preoperative prostate volume, resected prostate volume, rate of prostate resection [resected prostate volume/preoperative prostate volume x 100], operative time and duration of catheter were retrospectively analyzed to identify which of these were the factors related with AUR after catheter removal in post-TURP patients. RESULTS: Preoperative prostate volume was higher (90.7+/-50.4 vs 64.4+/-32.7, p=0.002) and rate of prostate resection was lower (38.8+/-8.1 vs 50.5+/-12.4, p<0.001) in AUR group compared to control group. And age, duration of symptoms, IPSS, QoL, uroflowmetry, post-void residual urine volume, preoperative serum PSA level, resected prostate volume, operative time and duration of catheter were not statistically significant in both groups. The multivariate analysis subsequently showed that preoperative prostate volume (p=0.010, OR=1.040) and rate of prostate resection (p=0.001, OR=0.901) were independent factors related with AUR after catheter removal in post-TURP patients. CONCLUSIONS: The incidence of AUR after catheter removal was higher in post-TURP patients with high preoperative prostate volume and low rate of prostate resection. Therefore the surgeon's effort to increase the rate of prostate resection, especially in patients with large prostate volume, may lower the incidence of postoperative AUR.

Cystic Lymphangioma of the Scrotum and Perineum / 대한남성과학회지

Cystic lymphangiomas are a benign tumor caused by lymphatic malformation. They are normally seen in the head and neck region and very rarely occur in the scrotum. We report a rare case of a 20-year-old man who presented with a gradually enlarging, painful scrotal mass which was identified ultrasonographically and histologically as a scrotal cystic lymphangioma and treated by surgical excision.

Corporeal Fibrosis and Erectile Dysfunction as Sequelae of Unrepaired Penile Blunt Trauma / 대한남성과학회지

Penile fracture is an injury caused by the rupture of the tunica albuginea. We report an uncommon case of penile fracture with corporeal fibrosis and erectile dysfunction in a 45-year-old man who sustained a straddle injury to the erect penis. He presented with palpable plaque in the bilateral proximal corpora cavernosa and markedly decreased erectile rigidity at the distal side of the plaque. Exploration and excision of the penile plaque were performed. The patient partially recovered erectile function after surgery and administration of phosphodiesterase-5 inhibitor.