Treatment of Bladder Tumors and Benign Prostatic Hyperplasia with a New TUR System Using Physiological Saline as Perfusate |
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Authors: | Rikio Yoshimura MD PhD Takahisa Adachi MD PhD Kiyoaki Funao MD Hitoshi Kobayakawa MD PhD Masahide Matsuyama MD PhD Kennji Tsuchida MD PhD Yoshiaki Takemoto MD PhD Tatsuya Nakatani MD PhD |
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Institution: | (1) Department of Urology, Osaka City University Medical School, 1-4-3 Asahi-machi, Abenoku Osaka, 545-8585, Japan;(2) Department of Urology, Sumiyama City Hospital, 1-2-16 Higashikagaya, Suminoe-ku, Osaka, Japan;(3) Department of Urology, Japan Railway Hospital, 1-2-22 Matsuzakichou, Abeno-ku, Osaka, Japan |
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Abstract: | This article presents a new transurethral resection (TUR) system for use in endoscopic surgery. By using an electroconductive
solution (physiological saline) as the perfusate in lieu of conventional non-electroconductive solution (Uromatic), additional
anesthesia (e.g., obturator nerve blocking) is not required. The new TUR is carried out in an electroconductive solution such
as saline, and because radiofrequency current flows from the resecting electrode through the perfusate to the outer sheath,
no counter-electrode is needed. We have treated both bladder tumor and benign prostatic hyperplasia cases with this new system.
Surgery was safely performed in all TUR-bt cases without requiring obturator nerve blocking. During both TUR-bt and transurethral
resection of the prostate (TUR-P) using this system, tissue resection and coagulation equivalents were similar to the conventional
TUR system. In previous TUR, preoperative obturator nerve blocking was necessary, and in some cases, incomplete blocking or
complications occurred. When physiological saline is used as the perfusate, blood electrolyte levels are not greatly changed,
even after extensive resection of the bladder wall; as a result, this new system is also cost effective because physiological
saline is less expensive than non-electroconductive solutions and requires no counter-electrode. Thus, in comparison with
conventional TUR, this new system is both significantly safer and more cost effective. |
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