Objective: To analyze the technical properties of transurethral
"sliced noodles-vaporesection" of prostate in the management of
benign prostatic hyperplasia.
Methods: 210 patients with obstructive BPH were treated
transurethrally by the "sliced noodles-vaporesection" technique
using the RevoIix 70W 2 micron continuous laser with only
one operator. We start the procedure with the marking of the
resection border at 5 and 7 o'clock positions deep to the surgical
capsule. Then performing Turner-Warwick like incisions at 5 and
7 o'clock positions to the surgical capsule joining to previous
marking resection. Combined with blunt dissection and incision,
we enucleate half of the median lobe.Then performing Sliced
Noodles-Vaporesection crosswisely. After this step, the lateral
lobes' resection was as well as the median lobes procedure.
During vaporesection, it is crucial to maintain the tissue chips
small enough to allow easy evacuation through the resectoscope
sheath at the end of the operation.
Results: Mean operation time was 62±19 (35-140) min. 6
patients need blood transfusion during the operation, mean
blood transfusion volume was 250 mL. Mean catheter time was
2.5±1.8 (1-6) d. Mean hospitalization time was 4.5±1.2 (4-7)
d. all patients were follow-up time for 3 to 6 months. Mean Qmax
increased from 6.8±2.5 mL/s preoperatively to 18.5±3.6 mL/
s 6 months postoperatively. IPSS and QoL-Score improved
from 22.4±5.5 and 4.8±0.8 to 5.3±3.2 and 1.6±1.1 6 months
postoperatively respectively (P<0.05). There were 3 cases had
external urethral strictures after operation, and treated with
urethral dilatation successfully.
Discussion: Through shaping the prostate tissue like a "paste"
and resecting piecely, we can concentrate our attention to
dissected the hole lobe from the surgical capsule. Then resecting
the tissue far away from the capsure. Morever, it allow laser fiber's
characteristic transverse movement to the full play in the paste
resection. thus it greatly improving The efficiency. In hemostasis
of the tissue, it can first resected the vessel from the root of the
lobe. then greatly reduced blood supply of the paste of tissue,so
keeping surgical vision clear and less prostate bleeding.
Conclusions: The method of "sliced noodles-vaporesection" of
the prostate using the 2 micron laser system is a feasible, rapid,
effective and safe procedure in the treatment of BPH.