| Objective:To assess the efficacy and the safety of a new transurethral endoscopic device for resection of the prostate using bipolar electrocautery, the Gyrus system , in the treatment of benign prostatic hyperplasia (BPH). This system permits rapid prostate tissue removal by endoscopic vaporization with little bleeding and no pad return using saline irrigation and therefore eliminating TURP syndrome. Methods:fourty five patients with symptomatic benign prostatic hyperplasia (BPH) without suspected cancer, confirmed by digital rectal examination and PSA tests, were treated between September 2003 and September 2004 with bipolar plasmakinetic electro-vaporization with saline irrigation and evaluated at 1 , 3 and 6 months postoperatively by the International Prostate Symptom Score (IPSS),maximum urinary flow rate (Qmax) and Quality of Life (QOL) .The median age was 70 years old (range from 57 to 83y), the median weight of the prostate was 53.9±28.5g (range from 20 to 151g.). International Prostate Symptom Score (IPSS) with a quality of life (QOL) scoring questionnaire, uroflowmetry (maximum flow rate; Qmax), residual urinevolume and prostate specific antigen (PSA) measurements had been performed beforesurgery.Results:the mean operative time was 75±29min (range from 30~150min), the mean weight of the resected tissue was 3 l±7g (range from 20 to 50g), one case needed blood transfusion during the operation (800ml), 2 hours postoperative indexes of Na+^ K+ and Cl-in the blood were (141±31) mmol/I^ (4.0±1.0) mmol/L> (101±17) mmol/L respectively, compared with the preoperative indexes ,there was no significant difference. No hyponatremia or transurethral resection syndrome occurred. No postoperative bleeding necessitating catheterization for postoperative retention occurred. The mean catheterization time was 4 days (2 to 6d). Urethral stricture occurred in 2 cases postoperation, and was treated by urethral dilatation for 2 weeks . The postoperative hospitalization was a mean of 8 days. The peak flow rate (Qmax) increased from 9.4±3.9 to 18.4±3.5> 19.2±3^ 20.6±2.8ml/s at 1,3 and 6 months respectively. The IPSS decreased from 25.2 to 6.8±1.8^ 5.9±1.6> 5.4±1.7; and the QOL decreased from 5.1 to 1.8 >. 1.5> 1.1 at 1, 3 and 6 months respectively. Postoperative values of IPSS, QOL, and Qmax showed significant improvement compared with preoperative values (p < 0.05). Conclusion:Transurethral bipolar plasmakinetic resection of the prostate is an effective and safe method with fewer complications. It is recommended for the treatment of BPH. |
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