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Medium term outcome of bipolar plasma vaporization in prostate cancer patients--a palliative modality of preserving spontaneous voiding.

Geavlete B, Moldoveanu C, Niţă G, Stănescu F, Jecu M, Geavlete P - J Med Life (2012)

Bottom Line: BPV was successfully performed in all cases with satisfactory efficiency, as confirmed by the mean operation time (42.8 minutes) and hemoglobin drop (0.7 g/dl).A fast and safe postoperative recovery period was described in this series (hematuria rate--7.5%; mean catheterization period--36 hours; mean hospital stay--2.5 days; early-irritative symptoms' rate--15%).These parameters emphasized a stable evolution throughout the entire follow-up, as 88.6% of the patients maintained spontaneous voiding.

View Article: PubMed Central - PubMed

Affiliation: Sf. Ioan Clinical Emergency Hospital, Department of Urology, Bucharest, Romania. bogdan_geavlete@yahoo.com

ABSTRACT

Objectives: This retrospective analysis evaluated the efficiency, safety, and medium term postoperative results of bipolar plasma vaporization (BPV) in prostate cancer (PCa) cases associating complete urinary retention.

Materials and methods: A series of 40 patients diagnosed with locally advanced or metastatic PCa and complete urinary retention requiring a Foley catheter indwelling underwent BPV aiming to restore spontaneous voiding. A total of 35 patients completed the one year evaluation protocol consisting of International Prostate Symptom Score (IPSS), quality of life score (QoL), maximum flow rate (Q(max)) and post-voiding residual urinary volume (PVR), measured at 1, 3, 6 and 12 months after surgery.

Results: BPV was successfully performed in all cases with satisfactory efficiency, as confirmed by the mean operation time (42.8 minutes) and hemoglobin drop (0.7 g/dl). A fast and safe postoperative recovery period was described in this series (hematuria rate--7.5%; mean catheterization period--36 hours; mean hospital stay--2.5 days; early-irritative symptoms' rate--15%). At 1, 3, 6 and 12 months, satisfactory values were determined in terms of IPSS, Qmax, QoL and PVR. These parameters emphasized a stable evolution throughout the entire follow-up, as 88.6% of the patients maintained spontaneous voiding.

Conclusions: The present trial confirmed the plasma-button vaporization as a promising therapeutic approach in PCa cases associating complete urinary retention. The technique displayed good efficacy, low perioperative morbidity, short convalescence, and satisfactory urodynamics and symptom score parameters during the one-year follow-up period.

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Related in: MedlinePlus

Specific endoscopic image of the invaded prostatic capsule after bipolar vaporization
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Figure 2: Specific endoscopic image of the invaded prostatic capsule after bipolar vaporization

Mentions: During BPV, the hemispherical shape electrode displaying a plasma corona on its surface was gradually moved in close contact with the prostatic tissue (Fig. 1), which was vaporized layer by layer until reaching the prostatic capsule (the so-called “hovering" technique) (Fig. 2). A virtually blood-less vaporization was produced at 280-320 W and larger vessels’ hemostasis was achieved at 120-140 W (Fig. 3). In all cases, a 20F Foley catheter was placed at the end of the procedure.


Medium term outcome of bipolar plasma vaporization in prostate cancer patients--a palliative modality of preserving spontaneous voiding.

Geavlete B, Moldoveanu C, Niţă G, Stănescu F, Jecu M, Geavlete P - J Med Life (2012)

Specific endoscopic image of the invaded prostatic capsule after bipolar vaporization
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3539841&req=5

Figure 2: Specific endoscopic image of the invaded prostatic capsule after bipolar vaporization
Mentions: During BPV, the hemispherical shape electrode displaying a plasma corona on its surface was gradually moved in close contact with the prostatic tissue (Fig. 1), which was vaporized layer by layer until reaching the prostatic capsule (the so-called “hovering" technique) (Fig. 2). A virtually blood-less vaporization was produced at 280-320 W and larger vessels’ hemostasis was achieved at 120-140 W (Fig. 3). In all cases, a 20F Foley catheter was placed at the end of the procedure.

Bottom Line: BPV was successfully performed in all cases with satisfactory efficiency, as confirmed by the mean operation time (42.8 minutes) and hemoglobin drop (0.7 g/dl).A fast and safe postoperative recovery period was described in this series (hematuria rate--7.5%; mean catheterization period--36 hours; mean hospital stay--2.5 days; early-irritative symptoms' rate--15%).These parameters emphasized a stable evolution throughout the entire follow-up, as 88.6% of the patients maintained spontaneous voiding.

View Article: PubMed Central - PubMed

Affiliation: Sf. Ioan Clinical Emergency Hospital, Department of Urology, Bucharest, Romania. bogdan_geavlete@yahoo.com

ABSTRACT

Objectives: This retrospective analysis evaluated the efficiency, safety, and medium term postoperative results of bipolar plasma vaporization (BPV) in prostate cancer (PCa) cases associating complete urinary retention.

Materials and methods: A series of 40 patients diagnosed with locally advanced or metastatic PCa and complete urinary retention requiring a Foley catheter indwelling underwent BPV aiming to restore spontaneous voiding. A total of 35 patients completed the one year evaluation protocol consisting of International Prostate Symptom Score (IPSS), quality of life score (QoL), maximum flow rate (Q(max)) and post-voiding residual urinary volume (PVR), measured at 1, 3, 6 and 12 months after surgery.

Results: BPV was successfully performed in all cases with satisfactory efficiency, as confirmed by the mean operation time (42.8 minutes) and hemoglobin drop (0.7 g/dl). A fast and safe postoperative recovery period was described in this series (hematuria rate--7.5%; mean catheterization period--36 hours; mean hospital stay--2.5 days; early-irritative symptoms' rate--15%). At 1, 3, 6 and 12 months, satisfactory values were determined in terms of IPSS, Qmax, QoL and PVR. These parameters emphasized a stable evolution throughout the entire follow-up, as 88.6% of the patients maintained spontaneous voiding.

Conclusions: The present trial confirmed the plasma-button vaporization as a promising therapeutic approach in PCa cases associating complete urinary retention. The technique displayed good efficacy, low perioperative morbidity, short convalescence, and satisfactory urodynamics and symptom score parameters during the one-year follow-up period.

Show MeSH
Related in: MedlinePlus