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Transurethral resection of prostate: a comparison of standard monopolar versus bipolar saline resection
Singhania, Piyush; Nandini, Dave; Sarita, Fernandes; Hemant, Pathak; Hemalata, Iyer.
  • Singhania, Piyush; B Y L Nair Hospital. T N Medical College. Department of Urology. Mumbai. IN
  • Nandini, Dave; B Y L Nair Hospital. T N Medical College. Mumbai. IN
  • Sarita, Fernandes; B Y L Nair Hospital. T N Medical College. Mumbai. IN
  • Hemant, Pathak; B Y L Nair Hospital. T N Medical College. Department of Urology. Mumbai. IN
  • Hemalata, Iyer; B Y L Nair Hospital. T N Medical College. Mumbai. IN
Int. braz. j. urol ; 36(2): 183-189, Mar.-Apr. 2010. tab
Article in English | LILACS | ID: lil-548378
ABSTRACT

INTRODUCTION:

Transurethral resection syndrome is an uncommon but potentially life threatening complication. Various irrigating solutions have been used, normal saline being the most physiological. The recent availability of bipolar cautery has permitted the use of normal saline irrigation. MATERIAL AND

METHODS:

In a randomized prospective study, we compared the safety and efficacy of bipolar cautery (using 0.9 percent normal saline irrigation) versus conventional monopolar cautery (using 1.5 percent glycine irrigation). Pre and postoperative hemoglobin (Hb) and hematocrit values were compared. Hemodynamics and arterial oxygen saturation were monitored throughout the study. Safety end points were changes in serum electrolytes, osmolarity and Hb/PCV (packed cell volume). Efficacy parameters were the International Prostate Symptom Score (IPSS) and Qmax (maximum flow rate in mL/sec) values.

RESULTS:

Mean preoperative prostate size on ultrasound was 60 ± 20cc. Mean resected weight was 17.6 ± 10.8 g (glycine) and 18.66 ± 12.1 g (saline). Mean resection time was 56.76 ± 14.51 min (glycine) and 55.1 ± 13.3 min (saline). The monopolar glycine group showed a greater decline in serum sodium and osmolarity (4.12 meq/L and 5.14 mosmol/L) compared to the bipolar saline group (1.25 meq/L and 0.43 mosmol/L). However, this was not considered statistically significant. The monopolar glycine group showed a statistically significant decline in Hb and PCV (0.97 gm percent, 2.83, p < 0.005) as compared to the bipolar saline group (0.55 gm percent and 1.62, p < 0.05). Patient follow- up (1,3,6 and 12 months postoperatively) demonstrated an improvement in IPSS and Qmax in both the groups.

CONCLUSION:

We concluded that bipolar transurethral resection of prostate is clinically comparable to monopolar transurethral resection of prostate with an improved safety profile. However, larger number of patients with longer follow up is essential.
Subject(s)

Full text: Available Index: LILACS (Americas) Main subject: Prostate / Prostatic Hyperplasia / Sodium / Transurethral Resection of Prostate Type of study: Controlled clinical trial / Observational study Limits: Humans / Male Language: English Journal: Int. braz. j. urol Journal subject: Urology Year: 2010 Type: Article Affiliation country: India Institution/Affiliation country: B Y L Nair Hospital/IN

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Full text: Available Index: LILACS (Americas) Main subject: Prostate / Prostatic Hyperplasia / Sodium / Transurethral Resection of Prostate Type of study: Controlled clinical trial / Observational study Limits: Humans / Male Language: English Journal: Int. braz. j. urol Journal subject: Urology Year: 2010 Type: Article Affiliation country: India Institution/Affiliation country: B Y L Nair Hospital/IN