PlasmaKinetic™ (bipolar) transurethral resection of prostate: a prospective trial to study pathological artefacts, surgical parameters and clinical outcomes

Introduction: The aims of the study were to compare the degree of cautery artefacts in prostatic chips between monopolar and PlasmaKinetic (TM) transurethral resection of prostate (TURP), and to determine if there is any difference in the intraoperative and post surgical parameters between them. Methods: After institutional review board approval, patients were prospectively enrolled to undergo PlasmaKinetic (TM) TURP. Their parameters were compared with those of the historical monopolar TURP controls. All histological specimens were reviewed by a single senior pathologist. Results: 46 patients were recruited to undergo PlasmaKinetic (TM) TURP. The resection time was significantly longer for the bipolar group compared to the monopolar group (50.2 versus 36.7 min, p-value is 0.001). The speed of resection (resection weight/time) was lower for the bipolar group (0.45 versus 0.56 g/min, p-value is 0.017). More irrigant was used for the bipolar group (21.2 versus 15.6 litres, p-value is 0.001) intraoperatively. There was no statistically significant difference in terms of intraoperative drop in haemoglobin and serum sodium change between the two groups. There seems to be a lesser degree of cautery artefacts in the PlasmaKinetic (TM) group than the monopolar group (42.17 versus 45.07 microns); however, this was not statistically significant (p-value is 0.452). Conclusion: Bipolar TURP seems to result in a lesser degree of cautery artefacts when compared to conventional monopolar TURP, albeit statistically insignificant, compared to monopolar TURP. TURP also resulted in a longer resection time and increased irrigant use, but no difference in blood loss and serum sodium levels.