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TheScientificWorldJOURNAL
Volume 7, Pages 1558-1562
http://dx.doi.org/10.1100/tsw.2007.241
Research Article

Bipolar Saline TURP for Large Prostate Glands

1Department of Urology, University of California Irvine Medical Center, Orange, CA, USA
2Department of Urology, Kaiser Permanente Medical Center, Irvine, CA, USA

Received 11 May 2007; Revised 8 August 2007; Accepted 21 August 2007

Academic Editor: Ziya Kirkali

Copyright © 2007 David S. Finley et al.

Abstract

The objective of this study was to evaluate the feasibility of bipolar transurethral resection of the prostate (TURP) in patients with very large prostate glands and significant comorbidities. Four patients with prostate glands >160 cc on preoperative volume measurement and ASA class three or higher underwent bipolar TURP with the Gyrus PlasmaKinetic system. Preoperative, operative, and postoperative parameters were studied. The results showed an average ASA class 3.25 (range: 3–4). The average preoperative prostate volume was 207.4 cc (range: 163–268). The average preoperative International Prostate Symptom Score (IPSS) and bother score was 31 and 6, respectively. Mean resection time was 163 min (range: 129–215). The weight of resected tissue and percentage of vaporized tissue was 80.8 g (range: 62–115) and 10.0% (range: 3.8–15.1), respectively. An average of 61L of saline was used (range: 48–78). The mean change in hemoglobin and serum sodium was 2.1 g/dl (range: 1.4–2.7) and 3.3 meq/l (range: 2–4), respectively. Postoperative catheter time averaged 76 h (range: 40–104). Mean length of hospital stay was 12 h (range: 4–24). The mean postoperative IPSS and bother score was 2.75 and 0.25, respectively. Bipolar TURP is a feasible alternative to simple open prostatectomy in high-risk patients with massive prostate adenomas. Prostate volume is reduced by approximately 10% due to vaporization.