Our experience with bipolar vaporesection of the prostate in treatment of benign prostatic hyperplasia

Benign prostatic hyperplasia (BPH) is one of the commonest diseases in older men. Operation is the most effective treatment modality. Monopolar surgery is slowly retracting itself, giving the way to the bipolar surgery. Bipolar transurethral vaporesection of prostate (TUVRB) is similar to the standard TURis with regard to the mechanism of action, but has some constructive peculiarities in the form of the loop electrode. 35 TUVRBs were performed in the urological center of the Dorozhnaya Clinical Hospital on the station Gorkiy OAO “RZD” during the period from January 2012 to August 2013. Mean patient age was 66 years (range 53 - 79). Mean IPSS and quality of life scores were 20.5 (15 - 31) and 4.5 (4 - 6), correspondingly. Mean Qmax was 8.09 ml/s (2 - 14), mean prostate volume - 47.6 sm 3 (20 - 104) and mean residual urine volume - 56.3 ml (33 - 170). Mean operation time was 56.8 min (30 - 100), mean expenditure of the saline for operation - 13.2 l (5 -30). The mean weight of the resected tissue was 24.8 g (10 - 57). Estimated volume of the blood loss was from 15 to 75 ml, 44.8 ml on average. Symptoms of the orthostatic urinary incontinence were present in 10 patients (28.5%) after operation. Therefore, TUVRB shows all advantages of the bipolar surgery with a minimal volume of the intraoperative blood loss. This is especially important in the patients with increased risk of bleeding.