A randomized controlled trial comparing the efficacy of hybrid bipolar transurethral vaporization and resection of the prostate with bipolar transurethral resection of the prostate
| Autor: | Ning Hong Chan, Peter K. F. Chiu, Kim W. M. Lee, Chi-Fai Ng, Sidney K.H. Yip |
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| Rok vydání: | 2011 |
| Předmět: |
Male
medicine.medical_specialty Urology media_common.quotation_subject medicine.medical_treatment Urination urologic and male genital diseases law.invention Randomized controlled trial law Prostate mental disorders medicine Dysuria Humans media_common Transurethral resection of the prostate Aged Demography Urinary retention business.industry Transurethral Resection of Prostate Surgery medicine.anatomical_structure Treatment Outcome Prostate surgery sense organs Laser Therapy medicine.symptom business Complication |
| Zdroj: | Journal of endourology. 25(12) |
| ISSN: | 1557-900X |
| Popis: | In comparison with monopolar transurethral resection of the prostate (TURP), bipolar TURP has been shown to have similar efficacy and complication profiles. Whether the hybrid technique of bipolar resection and vaporization of the prostate further improves catheterization time, dysuria, and complication profiles has not been defined, however. The objective of this study was to compare the efficacy and safety profile of bipolar hybrid prostate surgery using both resection and vaporization modes, with bipolar resection undertaken using the transurethral resection in saline bipolar system.This was a randomized controlled trial that compared bipolar hybrid surgery and bipolar resection of the prostate among men aged ≥ 50 years with benign prostatic hyperplasia (BPH) whose course of medical therapy had failed or who had recurrent urinary retention (CUHK_CCT00623). Patients were randomly assigned to receive either bipolar hybrid surgery or bipolar resection of the prostate. Both patients and assessors were blinded to the type of surgery performed. The primary study end point was catheter time. The secondary end points included postoperative hospital stay and dysuria score. We report the interim results for 86 patients.Forty-six patients were in the hybrid group and 40 were in the resection group. There were no differences between the two groups in prostate volumes (61.5 cc, standard deviation [SD]=34.5 vs 61.0 cc, SD=23.8), preoperative prostate-specific antigen levels (8.7 ng/mL, SD=8.5 vs 9.5 ng/mL, SD=8.4), or preoperative retention status (56.5% vs 70%). The mean operative time was 46.2 minutes for the hybrid group (SD=20.2) and 39.2 minutes for the resection group (SD=17.5). The hybrid group had a significantly shorter postoperative catheter time (34.5 h, SD=15.8 vs 44.7 h, SD=24.5, P=0.027). There was a significant difference between the two groups in the postoperative pain score on day 1 postsurgery (3.5 in the hybrid group vs 1.0 in the resection group, P=0.028). There was no difference between the groups in terms of changes in serum hemoglobin and serum sodium levels or the reintervention rate. All patients voided well after operation, with maximal flow improvements of 9.9 mL/s (SD 8.1) and 8.2 mL/s (SD 10.0) for the hybrid and resection groups, respectively, 1 month postsurgery.Transurethral bipolar resection and vaporization of the prostate reduces catheterization time and facilitates postoperative care. |
| Databáze: | OpenAIRE |
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