https://doi.org/10.4081/aiua.2023.11868

The role of irrigation fluid in transurethral resection of the prostate outcomes and surgeon performance

Vol. 95 No. 4 (2023)
Submitted: September 23, 2023
Accepted: October 13, 2023
Published: November 15, 2023
Prostate, Benign Prostatic Hyperplasia, Obstruction
Abstract Views: 1000
PDF: 331
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Authors

Federico Romantini
federomantini@gmail.com
https://orcid.org/0000-0002-0233-6654
Mazzini Hospital, Department of Urology, ASL Teramo, Teramo, Italy.
Daniela Biferi
Mazzini Hospital, Department of Urology, ASL Teramo, Teramo, Italy.
Guevar Maselli
Mazzini Hospital, Department of Urology, ASL Teramo, Teramo, Italy.
Federico Narcisi
Mazzini Hospital, Department of Urology, ASL Teramo, Teramo, Italy.
Maurizio Ranieri
Mazzini Hospital, Department of Urology, ASL Teramo, Teramo, Italy.
Luca Topazio
Mazzini Hospital, Department of Urology, ASL Teramo, Teramo, Italy.

Introduction: Transurethral resection of the prostate (TURP) is the gold-standard for the treatment of benign prostate enlargement (BPE) associated with lower urinary tract symptoms (LUTS), after failure of conservative therapy. At present, only resection-rate (grams of prostate resected over time) is regarded as an efficiency parameter to evaluate the skill of the operator and to assess the outcome of the procedure. Materials and methods: Five surgeons performed TURP using a Gyrus-type bipolar system in 123 patients with BPE/LUTS who came to our observation from June 2016 to December 2019. The amount of irrigation fluid used during the procedure was registered and correlated to the operating time, resection-rate, prostate adenoma weight, post-operative bladder irrigation time, intraoperative bleeding and days of catheterization. Results: We found an inverse correlation between the amount of irrigation fluid used during TURP and the resection-rate recorded for all operators, according to Spearman's Correlation (r = -0.78, p = 0.002); a direct correlation was also found between the amount of irrigation fluid and the adenoma weight. Finally, we also found a direct correlation with intraoperative bleeding and the duration and amount of bladder irrigation during and after TURP. Conclusions: The amount of irrigation fluid used is proposed as a reliable parameter to estimate the efficiency of the endoscopic procedure as well to assess the skill of the operator and shortterm results. The observed data encourage the possibility of applying this new efficiency indicator to all endoscopic maneuvers.

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Citations

Crossref
Scopus
Google Scholar
Europe PMC
EAU Guidelines. Edn. presented at the EAU Annual Congress Amsterdam 2022. ISBN 978-94-92671-16-5.
Cury J, Coelho RF, Bruschini H, Srougi M. Is the ability to perform transurethral resection of the prostate influenced by the surgeon’s previous experience? Clinics. 2008; 63:315-20. DOI: https://doi.org/10.1590/S1807-59322008000300005
The Oxford English Dictionary, Oxford University Press, 2019.
Skolarikos A, Rassweiler J, de la Rosette JJ, et al. Safety and Efficacy of Bipolar Versus Monopolar Transurethral Resection of the Prostate in Patients with Large Prostates or Severe Lower Urinary Tract Symptoms: Post Hoc Analysis of a European Multicenter Randomized Controlled Trial. J Urol. 2016; 195:677-84. DOI: https://doi.org/10.1016/j.juro.2015.08.083
Kallstrom R, Hjertberg H, Kjolhede H, et al. Use of a virtual reality, real-time, simulation model for the training of urologists in transurethral resection of the prostate. Scand J Urol Nephrol. 2005; 39:313-20. DOI: https://doi.org/10.1080/00365590510031246
Huang X, Wang L, Wang XH, et al. Bipolar transurethral resection of the prostate causes deeper coagulation depth and less bleeding than monopolar transurethral prostatectomy. Urology. 2012; 80:1116-1120. DOI: https://doi.org/10.1016/j.urology.2012.07.024
Mamoulakis C, Ubbink DT, de la Rosette JJ. Bipolar versus monopolar transurethral resection of the prostate: a systematic review and meta-analysis of randomized controlled trials. Eur Urol. 2009; 56:798-809. DOI: https://doi.org/10.1016/j.eururo.2009.06.037
Huang X, Wang XH, Wang HP, et al. Comparison of the microvessel diameter of hyperplastic prostate and the coagulation depth achieved with mono- and bipolar transurethral resection of the prostate. A pilot study on hemostatic capability. Scand J Urol Nephrol. 2008; 42:265-268. DOI: https://doi.org/10.1080/00365590701702168
Tan GH, Shah SA, Ali NM, et al. Urethral strictures after bipolar transurethral resection of prostate may be linked to slow resection rate. Investig Clin Urol. 2017; 58:186-191. DOI: https://doi.org/10.4111/icu.2017.58.3.186

How to Cite

Romantini, F., Biferi, D., Maselli, G., Narcisi, F., Ranieri, M., & Topazio, L. (2023). The role of irrigation fluid in transurethral resection of the prostate outcomes and surgeon performance. Archivio Italiano Di Urologia E Andrologia, 95(4). https://doi.org/10.4081/aiua.2023.11868
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