Five-Year Follow-Up Results of a Randomized Controlled Trial Comparing Bipolar Plasmakinetic and Monopolar Transurethral Resection of the Prostate

PURPOSE: To report the 5-year follow-up results of a randomized controlled trial comparing bipolar transurethral resection of the prostate (TURP) with standard monopolar TURP for the treatment of benign prostatic obstruction (BPO). MATERIALS AND METHODS: A total of 220 patients were randomized to bipolar plasmakinetic TURP (PK-TURP) or monopolar TURP (M-TURP). Catheterization time was the primary endpoint of this study. Secondary outcomes included operation time, hospital stay, as well as decline in postoperative serum sodium and hemoglobin levels. All patients were assessed preoperatively and followed-up at 1, 6, 12, 24, 36, 48, and 60 months postoperatively. Parameters assessed included quality of life, transrectal ultrasound, serum prostate-specific antigen level, postvoid residual urine volume, maximum urinary flow rates (Qmax), and International Prostate Symptom Score. Patient baseline characteristics, perioperative data including complications, and postoperative outcomes were compared. Complication occurrence was graded according to the modified Clavien classification system. RESULTS: PK-TURP was significantly superior to M-TURP in terms of operation time, intraoperative irrigation volume, resected tissue weight, decreases in hemoglobin and sodium, postoperative irrigation volume and time, catheterization time, and hospital stay. At 5 years postoperatively, efficacy was comparable between arms. No differences were detected in safety outcomes except that the clot retention rate was significantly greater after M-TURP. CONCLUSION: Our results indicate that PK-TURP is equally as effective in the treatment of BPO, but has a more favorable safety profile in comparison to M-TURP. The clinical efficacy of PK-TURP is long-lasting and comparable with M-TURP.

Spermatic vein and artery ligation for varicocele / 中华男科学杂志

<p><b>OBJECTIVE</b>To assess the influence of spermatic vein and artery ligation on testicular hemodynamics, spermatogenesis and testis volume in varicocele patients.</p><p><b>METHODS</b>Eighty-eight varicocele patients were randomly divided into a spermatic vein and artery ligation (n = 46) and a spermatic vein and artery preservation group (n = 42). The testicular hemodynamic parameters, testis volume and results of semen analyses were obtained before and 6 months after the surgery and compared between the two groups.</p><p><b>RESULTS</b>There were no significant differences in peak systolic velocity (V(max)), end diastolic velocity (V(min)), mean enveloped velocity (V(mean)) and V(min) of the capsular artery (CA) either between the ligation and preservation groups (P > 0.05) or between pre- and post-operation (P > 0.05). Sperm density, vitality and motility were significantly improved after surgery (P < 0.01), with no significant differences between the two groups (P > 0.05). No significant difference was found in the testis volume between the two groups before and after the operation (P > 0.05).</p><p><b>CONCLUSION</b>Spermatic vein and artery ligation in varicocelectomy does not affect the testicular hemodynamics, spermatogenesis and testis volume of varicocele patients. Both the spermatic vein and artery should be ligated when necessary.</p>