Use of a novel ex-vivo model to compare the hemostatic properties of plasmakinetic resection, transurethral vaporization resection and conventional transurethral resection of the prostate

OBJECTIVES To compare the hemostatic properties of transurethral plasmakinetic resection of the prostate (PKRP), transurethral vaporization resection of the prostate (TUVRP) and transurethral resection of the prostate (TURP) ex vivo, as perioperative bleeding is still regarded as one of major complications of transurethral prostatectomy. METHODS The modified model of isolated normal saline (NS)-perfused porcine kidney was used to determine the hemostatic efficacy of PKRP, TUVRP, and TURP. The loss of normal saline was semiquantitatively measured in relation to tissue ablation for the 3 techniques and specimens were evaluated histologically. RESULTS The median values of NS loss rate of PKRP, TUVRP, and TURP were 4.02, 3.74, and 6.51 mL/min, respectively. The NS loss rate of TUVRP and PKRP were obviously lower than that of TURP (P <0.05). The difference between the NS loss rate of PKRP and TUVRP was not significant (P >0.05). The median values of depths of the coagulation zones of PKRP, TUVRP, and TURP were 217, 292, and 140 mu m, respectively. Coagulation depth with TURP was significantly smaller than that with TUVRP and PKRP (P <0.05). Coagulation depth with PKRP was also smaller than that with TUVRP (P <0.05). CONCLUSIONS PKRP is comparable with TUVRP in hemostasis and both of them could cause significantly less perioperative bleeding than TURP.