ABSTRACT
PURPOSE: To compare the efficacy and safety of the PlasmaKinetic (PK) Superpulse system with that of conventional transurethral resection of the prostate (TURP) in terms of restoration of urinary flow and early postoperative course. PATIENTS AND METHODS: One hundred five men older than 45 years with lower-urinary tract symptoms associated with benign prostatic hyperplasia (BPH) were randomized, 51 undergoing standard TURP with glycine as the irrigation fluid and 53 TURP with the PK Superpulse system with normal saline as irrigant. The operative time, intraoperative blood loss, catheter time, change in serum electrolytes (particularly sodium), and uroflowmetry and American Urological Association (AUA) Symptom Scores were compared. RESULTS: The blood loss as well as the catheter time observed in the PK Superpulse arm were significantly less than those in the conventional-TURP arm. The mortality rate was 0 in both the arms. The mean operative time was less in the PK Superpulse arm, although not significantly so. Hyponatremia was statistically insignificant. Significant changes were observed in the AUA Scores in both arms. CONCLUSION: The PK Superpulse system provides faster removal of tissue in a bloodless field with better views and a safer environment of saline irrigation with efficacy comparable to that of conventional TURP. However, further randomized trials with extended follow-up may be needed to better define the role of the PK Superpulse system in treating patients with symptomatic BPH.
Subject(s)
Blood Loss, Surgical , Prostatic Hyperplasia/surgery , Therapeutic Irrigation/instrumentation , Transurethral Resection of Prostate/methods , Aged , Follow-Up Studies , Glycine/pharmacology , Humans , Kinetics , Length of Stay , Male , Middle Aged , Pain, Postoperative/physiopathology , Postoperative Care , Postoperative Complications/diagnosis , Postoperative Complications/therapy , Probability , Prostatic Hyperplasia/diagnosis , Reference Values , Risk Assessment , Sensitivity and Specificity , Transurethral Resection of Prostate/adverse effects , Treatment Outcome , Urinary Catheterization , VolatilizationABSTRACT
A 65-year-old man with a 5.5 x 3.2-cm stage T(2)N(0)M(0) grade III renal-cell carcinoma suffered a port-site metastasis 8 months after laparoscopic radical nephrectomy with specimen removal in an organ-retrieval bag. This case underlines the need to be conversant with, and care to avoid, risk factors for this complication.
