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TURis plasma vaporization combines the advantages of laser procedures and classical peeling
Cologne, Germany, January 27, 2009 - Patients with benign prostate enlargement now have access to a new procedure for the surgical removal of excess prostate tissue: TURis (Transurethral Resection in Saline) plasma vaporization. Surgical complications such as urinary incontinence, impotence and, above all, the potentially life-threatening enema syndrome can be virtually avoided with this gentle and minimally invasive procedure. "TURis plasma vaporization thus offers decisive advantages over conventional peeling of the prostate," emphasizes Dr. Stephan Neubauer, urologist at the West German Prostate Center in Cologne. "Especially older and sicker patients, as well as patients with an increased risk of bleeding, benefit from the new method."
Constant urination, a weak urine stream and unpleasant dribbling at night - what becomes a nightmare for many men is usually due to benign enlargement of the prostate. It affects almost every second man over 50 and almost every 80-year-old. In so-called benign prostatic hyperplasia (BPH), the glandular tissue of the prostate grows into the area of the urethra. As a result of the narrowing of the urethra, the strength of the urine stream decreases and residual urine remains in the bladder. This in turn can lead to painful inflammation and promote the formation of bladder stones.
In the early stages, the symptoms can usually be effectively alleviated with medication. However, if these do not lead to the desired success, the excess tissue usually has to be removed surgically. The standard procedure is still the classic excision (transurethral prostate resection/TURP). Using a wire loop over which an electric current flows, excess tissue is removed layer by layer. "The current flowing from the working electrode through the patient's body to the neutral electrode can cause significant irritation and damage to tissue. Thus, urethral strictures, rarely erectile dysfunction and, in very rare cases, urinary incontinence may occur," Neubauer explains. A serious complication known as TUR syndrome occurs in about two percent of patients treated. In this case, irrigation fluid enters the bloodstream through opened blood vessels. As a result, there is a change in the electrolyte situation and thus a strain on the circulation. In the worst case, the flushing fluid can lead to shock, pulmonary or cerebral edema.
Lower risk of bleeding, high efficacy, and shorter layover times
A new minimally invasive procedure known as TURis plasma vaporization can now provide a remedy. In contrast to the classic peeling procedure, well-tolerated saline solution is used instead of hypotonic irrigation solution. This prevents the potentially life-threatening TUR syndrome. Another advantage is that the current does not flow through the entire body, but only where the tissue is to be removed. "Irritation of surrounding organs can thus be minimized and current-related side effects largely avoided," Neubauer explains.
The surgeon can combine two different techniques with the innovative system: planing (resection) with the help of electric current and vaporization (vaporization) through the use of a vaporization electrode. The plasma vaporization electrode vaporizes the tissue in a similar way to a laser, but without generating intense heat. At the same time, the tissue is scabbed over, thus preventing bleeding from the outset The vaporization electrode is mainly used in the area of mucous membranes with a strong blood supply. "The prostate tissue behind it is permeated by fewer blood capillaries and can now be planed off with the electric snare," explains the Cologne urologist. The tissue shavings produced during resection can be examined by the pathologist for tumor cells.
Thanks to the unique combination of vaporization and electric snare, the respective electrode can be selected and inserted into the prostate via the working channel as required, i.e., whether hemostasis or tissue removal is the primary objective. Another plus is the shortened operating time. "This makes the procedure particularly attractive for patients who tend to have a high risk of bleeding and suffer from concomitant diseases such as cardiovascular disease.
As one of the few centers in Germany, the West German Prostate Center now also has the innovative TURis plasma vaporization in addition to TUR-P, TUNA and the state-of-the-art laser procedures (Greenlight laser and Life diode laser). "This gives us a comprehensive range of minimally invasive and surgical treatment options for benign prostate enlargement, allowing us to decide individually for each patient which method is best suited," Neubauer sums up.