Electrovaporization of the prostate with the Gyrus device

Purpose: To assess the efficacy and the safety of a new transurethral endos copic device using bipolar electrocautery, the Gyrus system. This system pe rmits rapid prostate tissue removal by endoscopic vaporization with little bleeding and no pad return using saline irrigation and therefore eliminatin g TURF syndrome, Patients and Methods: Forty-two patients (mean age 70; range 49-90 years) w ith symptomatic benign prostatic hyperplasia (BPH) without suspected cancer , confirmed by digital rectal examination and PSA tests, were treated betwe en October 1998 and February 1999 with the Gyrus and evaluated at 1 and 3 m onths postoperatively by the International Prostate Symptom Score (IPSS) an d maximum urinary flow rate. Results: No postoperative bleeding necessitating catheterization for postop erative retention occurred. The duration of the procedure was less than or equal to 30 minutes in 12 patients, 30 to 60 minutes in 27 patients, and >6 0 minutes in 3 patients. The mean time of postoperative continuous bladder irrigation was 1.2 days (0.5-3 days), The mean catheterization time was 1.4 days (range 0.5-5 days). Urethral stricture requiring treatment occurred i n two patients, Dysuria was reported by four patients (mild two, severe two ). The postoperative hospitalization was a mean of 2.2 days. The mean peak flow rate increased from 7.9 to 19.7 mL/sec at 3 months, and the IPSS decre ased from 16 to 9 at 3 months. Conclusion: Our preliminary results with a bipolar electrode for electrovap orization of the prostate using the Gyrus suggest that it is a useful and s afe endoscopic device, It appears to be an effective treatment for BPH; how ever, long-term results (i.e., 1-year follow-up) should be evaluated. This pilot series permits a comparative study with TURF to assess the benefits f or patients and the health care system.