Improved Continuous Flow Transurethral Prostatectomy

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Abstract
Two continuous flow resectoscopes for transurethral resection of the prostate were compared: a new intrinsic bladder pressure-controlled drainage system and the suction drainage system. In 31 patients undergoing transurethral prostatic resection who were assigned randomly to a pressure-controlled (17) or suction drainage (14) resectoscope group, the required irrigant volume and operative blood loss (ml/g resected tissue) were appreciably less with pressure-controlled drainage, while the resection rate (g/min) was significantly greater. Irrigant absorption, as evidenced by weight gain and changes in hematocrit, serum osmolality and serum sodium, was minimal in either group, with no significant difference between the 2 methods. In addition, there was no significant difference in intraoperative intravesical pressure between the 2 groups. The suction drainage system led to pump drainage failure in certain rotational positions, resulting in diminished visibility and increased resection time. The pressure-controlled drainage system required no suction devices or adjustments, thus, allowing constant improved visibility and uninterrupted resection. These results suggest that the efficiency and ease of transurethral prostatic resection are superior with the pressure-controlled continuous flow drainage system than with the suction drainage system.