Department of Urology, St Gallen Cantonal Hospital, St Gallen, Switzerland.
Prostate Cancer Prostatic Dis. 2010 Sep;13(3):285-91. doi: 10.1038/pcan.2010.1. Epub 2010 Feb 9.
We compared bipolar and monopolar TURP in a prospective controlled study at two urology centers. The objective of the study was to establish whether there were differences between the two methods with regard to frequency of the transurethral resection (TUR) syndrome, amount of fluid absorbed during surgery, risk of hemorrhage, duration of postoperative catheterization and duration of hospitalization. The duration of surgery, improvement in maximum flow rate (Q-max), residual urine volume, International Prostate Symptom Score (IPSS) and Quality of Life (QoL) score were also compared. Overall, our study showed that there were no major differences between bipolar and monopolar TURP. During follow-up, the clinical efficacy of bipolar TURP has been maintained to the same degree as with the traditional method, with no significant differences for Q-max, IPSS and QoL scores after 1 year. Although the risk of developing TUR syndrome seemed to be smaller with bipolar resection (serum sodium change bipolar versus monopolar: +1.2 versus -0.1 mmol l(-1)), the bleeding tendency with both methods was the same (14.0 g l(-1) hemoglobin loss after 1 day in both groups). On the basis of our findings, we think that the monopolar technique has still a place in TURP.
我们在两家泌尿科中心进行了一项前瞻性对照研究,比较了双极和单极 TURP。该研究的目的是确定两种方法在经尿道前列腺切除术 (TUR) 综合征的频率、手术中吸收的液体量、出血风险、术后导管插入时间和住院时间方面是否存在差异。还比较了手术时间、最大流量 (Q-max) 改善、残余尿量、国际前列腺症状评分 (IPSS) 和生活质量 (QoL) 评分。总的来说,我们的研究表明,双极和单极 TURP 之间没有重大差异。在随访期间,双极 TURP 的临床疗效与传统方法保持一致,1 年后 Q-max、IPSS 和 QoL 评分无显著差异。尽管双极切除似乎降低 TUR 综合征的风险(血清钠变化:双极比单极:+1.2 比 -0.1 mmol l(-1)),但两种方法的出血倾向相同(两组术后第 1 天血红蛋白丢失 14.0 g l(-1))。基于我们的发现,我们认为单极技术在 TURP 中仍然占有一席之地。