The objective of this study was to assess the safety and efficacy of rotoresection as a method for treating benign prostatic hyperplasia (BPH).
Thirty patients were prospectively enrolled between September 2000 and May 2001 (mean age 61 years, sd 6, range 52–78).
All patients had a symptom score (AUA) of > 12, a maximum urinary flow rate (Qmax) of < 12 mL/s, a prostate of 20–80 mL and a prostate-specific antigen (PSA) level of 0–4 ng/mL.
Patients with prostate or bladder cancer, a PSA level of > 10 ng/mL, previous prostate surgery, previous pelvic surgery, urethral stricture, active urinary tract infection (UTI), acute urine retention, neuropathic bladder and a serum creatinine of > 1.8 mg/mL were excluded.
The adenoma was resected using the Rotoresect® system (Karl Storz, Tuttlingen, Germany); the mean (sd) operative duration was 45.2 (9.9) min. The catheter was removed after 1.97 (0.3) days and patients assessed at 1, 3 and 6 months after surgery by an AUA score, Qmax, blood haemoglobin level, urine analysis and transrectal ultrasonography; all patients but two completed the follow-up.
RESULTS: At 6 months the mean (sd) AUA score decreased from 20.5 (3.8) to 1.6 (1.3), the Qmax increased from 8.7 (2) to 25.3 (12.6) mL/s, and the total prostate volume decreased from 36.5 (13) to 20.5 (7.8) mL.
The mean initial haemoglobin level was 138 (10) g/L and at 1 month was 135 (12) g/L. No patient required a blood transfusion or had signs of transurethral resection syndrome.
Early complications included UTI and mild stress incontinence in 10 and 11 patients, respectively. At 6 months these patients had sterile urine and were continent.
Two patients had a urethral stricture and posterior urethral stone at 6 months and were treated successfully.
CONCLUSION: In the short-term, rotoresection is a safe and effective method for treating BPH; there was no significant blood loss or resection syndrome. The hospital stay was short, with excellent functional results.
Source: B.S. Wadie, A.B. Shehab El-Dein, A.M. Mohamed, S.M. Elhalwagy, M.A. Ghoneim (2003): Short-term results of rotoresection for benign prostatic hyperplasia: a prospective study of safety and efficacy. In: BJU International 92 (7) , 710–712
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