Bipolar saline TURP for large prostate glands

Area of Science:

• Urology
• Minimally Invasive Surgery

Background:

• Benign prostatic hyperplasia (BPH) is common in older men.
• Large prostate glands (>160 cc) and significant comorbidities pose challenges for traditional surgical interventions.
• Bipolar transurethral resection of the prostate (TURP) is an option, but its feasibility in massive prostates with high-risk patients is less understood.

Purpose of the Study:

• To evaluate the feasibility and outcomes of bipolar TURP for very large prostate glands (>160 cc) in patients with high comorbidity scores (ASA class III or higher).

Main Methods:

• A prospective study involving four patients with massive prostate adenomas (average volume 207.4 cc) and high ASA scores (average 3.25).
• All patients underwent bipolar TURP using the Gyrus PlasmaKinetic system.
• Preoperative, operative, and postoperative parameters including International Prostate Symptom Score (IPSS), prostate volume reduction, blood loss, and hospital stay were analyzed.

Main Results:

• Bipolar TURP was successfully performed in all four high-risk patients.
• Average resection time was 163 minutes, with 80.8 g of tissue resected.
• Significant improvement in IPSS (31 to 2.75) and bother scores (6 to 0.25) was observed.
• Mean postoperative catheterization was 76 hours, and mean hospital stay was 12 hours.
• Average prostate volume reduction was approximately 10% due to vaporization.

Conclusions:

• Bipolar TURP is a feasible and effective alternative to simple open prostatectomy for high-risk patients with massive prostate adenomas.
• The procedure demonstrates good safety and efficacy, leading to substantial symptom relief and reduced hospital stay.