Süleyman Barış KARTAL, Hakan ERÇİL, Faruk KUYUCU, Ediz VURUŞKAN, Nevzat Can ŞENER, Adem ALTUNKOL, Zafer Gökhan GÜRBÜZ

Plazmakinetik Enerji Teknolojisi Kullanılarak Transüretral Prostat Rezeksiyonu Yapılan benign Prostat Hiperplazi Hastalarının Kısa Dönem Sonuçlarının Değerlendirilmesi

Amaç: Bu çalışmamızda Plasma Kinetik Doku Tedavi Sistemi ile transüretral rezeksiyon (TURP) yapılan, semptomatik benign prostat hiperplazili (BPH) hastaların kısa dönem sonuçlarını inceleyerek, Plasma Kinetik Doku Tedavi Sisteminin etkinlik ve yan etki profilini ortaya koymaya çalıştık. Materyal ve Metod: Mart 2011 ile şubat 2012 tarihleri arasında kliniğimize başvuran benin prostat hiperplazi (BPH) tanısı ile ameliyat kararı alınan 86 hasta çalışma kapsamına alındı. Hastaların; IPPS semptom skorlaması, üroflowmetri, artık idrar miktarı tayini, prostat hacimleri, belirlendi. Tüm hastaların ameliyat sonrası üretra darlığı, mesane boyun darlığı, inkontinans gibi erken ve geç istenmeyen yan etkileri kaydedildi. Hastalar ameliyat süreleri, ameliyat sırasında kullanılan irrigasyon sıvısı miktarı ve transfüzyon gerekliliği, ameliyat sonrası hastanede kalış ve katerizasyon süreleri, irrigasyon sıvısı miktarları kaydedildi. 6.ayda hastalardan elde edilen veriler ameliyat öncesi verilerle kıyaslandı. Ameliyatı gerçekleştiren doktorlara görüntü kalitesinin 0"dan 10"a doğru artış gösterdiği söylendikten sonra, skala üzerinde kişisel derecelendirme yapmaları istendi. Bulgular: Çalışmaya dahil edilen 86 hastadan 24"ünün başvuru nedeni akut üriner retansiyona bağlı olarak gelişen glob vezikale idi. Bir hastada yatış endikasyonu hematüri nedeniyle olmuştu. Çalışmaya alınan hastaların operasyon öncesi IPSS değerlerinin genel ortalaması 22,2 idi. Postoperatif 6.aydaki sorgulamalarında ortalama IPSS değeri 6,8 olarak tespit edilmiştir. Operasyondan hemen sonra, rezektoskopun çıkarılmasını takiben, cerrahın cerrahi alan görüntü kalitesini ölçmeyi hedefleyen VAS skoru ortalaması 7,41, cihazın kanama kontrolü yeteneğini ölçmeyi hedefleyen VAS skoru ortalaması 7,62 bulunmuştur. Sonuç: Çalışmamızda ortaya çıkan sonuçlar ve literatür verileri kılavuzluğunda; bipolar TURP teknolojisinin, mesane çıkım obstrüksiyonuna yol açmış benign prostat hiperplazisinin endoskopik cerrahi tedavisinde daha iyi hemodinamik stabilite ve cerrahi işlem sırasında daha yüksek konfor sağlaması nedeniyle monopolar TURP uygulamalarına iyi bir alternatif olduğu kanısına vardık.

Anahtar Kelimeler:

Prostat, Plazmakinetik, TUR

Evaluation of short term outcomes of patients undergone transurethral resection with plasmakinetic energy for benign prostate hyperplasia

Aim: To evaluate short term outcomes of patients undergone transurethral resection with plasmakinetic energy for benign prostate hyperplasia and to present safety and efficacy of the procedure. Material and Method:86 patients applied to our clinic between March 2011 and February 2012 were enrolled into the study. PSS scores, uroflowmetry, post voiding residual urine, prostate volumes of the patients were recorded. Post operative urethral stricture, bladder neck stricture, incontinance rates were noted. Data assessed after six months were compared to peroperative data. After the operations, the surgeons evaluated their comfort of surgery with visual analog scale from 0 to 10. Results: 24 of 86 patients were hospitalized for acute urinary retention. One patient was hospitalized because of hematuria. Peroperative IPSS was 22.2. at post operative sixth month, mean IPSS was 6.8. VAS scores of surgeons was; to assess visual comfort was 7.41, to assess coagulation was 7.62. Conclusion:After evaluating the data and literature, we believe bipolar plasmakinetik TUR is a safe and comforting method to treat bladder outlet obstruction with goog hemodynamic stability.

Keywords:

Prostate, Plasmakinetic, TUR,

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Yazışma Adresi / Address for Correspondence: Dr. Nevzat Can Şener Sağlık Bakanlığı Adana Numune E ğİtim ve Araştırma Hastanesi, Üroloji Kliniği Yüreğir/ADANA Tel: +90 505 3328474 geliş tarihi/received :20.04.2013 kabul tarihi/accepted:21.05.2013