A Comparative Study On The Safety Of Transurethral Electrovaporization Of The Prostate And Transurethral Resection Of The Prostate

Objectives: To compare transurethral electrovaporization of the prostate (TUVP) with transurethral resection of the prostate (TURP) on the operative safety using intraoperative determinate of blood loss, irrigation fluid absorption, blood sugar and electrolytes changes and complications, Meanwhile, to discass the pathogenesis of complications related to TUR and its management and prevention.Patients and methods: Control qroup (group A) included 40 patients who underwent TURP, Other 40 patients undergoing TUVP as study group (Group B). Absorption of irrigation fluid was quantified by analyzing the serum concentration of gentamycin which was used as an indicator of fluid absorption. Blood loss of TURP and TUVP patients was calculated in teems of the formula as the product of irrigating fluid volume used and hemoglobin concerntration (determined with a instrument of STKS) divided by preoperative blood hemoglobin concentation. Blood electrolytes and sugar were checked just before and fifteen minutes each during operation andimmediately after operation. Patient's arterial blood pressure, heart rate and reaction were also carefully observed during and after operation, and complications, if any, were takendown. All data were analyzed with SPSs software package.Results: blood loss in study group was singficatly less than that in control group (101.51 ?18.75ml vs 393.95 + 96.23ml, PO.001), absorption of irrigation fluid in study group was significantly less than that in control group too. (119.17+ 19.95ml vs 481.79+108.11ml, PO.001), and reduction of serum sodium concentration is much more obviously in control group than that in study group (3.34?.33mmol/L vs 0.77?.7mmol/L, P<0.01). However, the incidence of hypotension and TURS in control group was significantly higher than that in study group (12.5% vs 2.5% and 4/40 vs 0/40, PO.05). The incidence of complication in control group was significantly higher than that in study group when the prostate weight was> 45g and the operative time was >90minute. (6/19 vs 1/21 and 6/15 vs 1/20, PO.05), this was the same in patients with medical history of caidiovascular and respiratory disorders (7/16 vs 1/19, PO.05, 4/15 vs 1/19, PO.01). Conclusions: The blood loss and absorption of irrigating fluid during TURP issignificantly greater than that in group of TUVP. 2. The incidence of hypotension and TURS during TURP is higher than that in TUVP, and the changes of the concentration of blood sugar and electrolytes during TURP is more obvious than that in TUVP. 3. The more suitable operation for patients with prostate weight>45g, the operative time>90 minute, or has a medical history of cardiovascular and respiratory disorders would be TUVP. 4. The operation of TUVP is more safer than that of TURP.