OUTCOME AND SAFETY OF BIPOLAR TRANSURETHRAL RESECTION IN SALINE (TURIS) IN B.P.H PATIENTS WITH RETENTION OF URINE

Background and aim: Transurethral resection of prostate is the gold standard for the treatment of benign prostatic hyperplasia. To reduce the risks of the monopolar circuit, resectoscopes are today commercially available, which by behaving like electric dipoles, allow the patient to be excluded from the circuit. This allows the use of physiologic saline as irrigation solution annulling the risk of a TUR syndrome and intoxication by glycine. In the literature many papers confirm the equivalence in clinical outcome between mono and bipolar resection (5) but there is currently little available data on the more effective safety of bipolar devices. This study was done to asses outcome and safety of TURIS in B.P.H patients with retention of urine

Objective: This study was addressed to asses outcome and safety of TURIS in B.P.H patients with retention of urine at our institute.

Patient and methods: Between (January 2014 and August 2018), 285 patients of B.P.H with retention of urine underwent TURIS at our institute. All the procedures were carried out on bipolar device equipment Autocon® 400 ESU in normal saline (0.9%). The resectoscope used was 26 FR (Karl Storz) loop = 24 FR size with continuous irrigation system.

Results: Age of the patients ranged from 50 to 85 years and volume of prostate ranged from 40 – 100 gm. The postoperative follow up ranged from 3 months to 20 months. None of the patients developed TURP syndrome or skin burns. Post operatively 7 patients (2.4%) developed haematuria necessitating blood transfusion and 3(1.05%) needed redo fulguration. Two (0.7%) developed orchitis, none of the patients developed renal failure and TURP syndrome. Out of 285 patients 270 (94.7%) were catheter free. In long term follow up two (0.70%) patient developed stricture urethra and none bladder neck contracture during follow up.

Conclusion: Our results demonstrates that TURIS is safe and efficacious in B.P.H patients with retention of urine with minimum morbidity and no mortality it avoids the risk of TURP syndrome but with more episodes of bleeding.

Keywords: TURP, TURIS, Monopolar, Bipolar