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Transurethrale Resektion der Prostata und Modifikationen (bipolar, Elektrovaporisation)

Transurethral resection of the prostate and current modifications (bipolar, electrovaporization)

Zusammenfassung

Die transurethrale Resektion der Prostata (TURP) ist das operative Referenzverfahren, da sich über einen minimal-invasiven natürlichen Zugangsweg eine effektive Entfernung der benignen Prostatahyperplasie erreichen lässt, was zu einer relevanten und nachhaltigen Verbesserung der Symptomatik und Lebensqualität, der Miktionsparameter und der Obstruktion führt. Bei der TURP wird das Gewebe mittels hochfrequentem (HF-)chirurgischem Schnitt mit schnittsynchroner Blutstillung abgetragen. Viele Modifikationen der TURP (z. B. die Video-TURP) haben sich allgemein durchgesetzt und den Standard verändert. Grund für weitere Modifikationen war die Verbesserung der im Einzelfall unausgewogenen Balance zwischen Schnitt und Blutstillung zugunsten einer Verbesserung der Blutstillung. Dies konnte mit verschiedenen Modifikationen (HF-Modulation, Bandschlinge und bipolare Resektion) oder neuen Verfahren (Vaporisation und Enukleation) erreicht werden, die den Standard der TURP zwar bisher nicht verdrängt haben, aber sich daneben etablierten.

Abstract

Transurethral resection of the prostate (TURP) is the surgical standard which is truly minimally invasive by using a natural orifice and is also of durable efficacy. The use of TURP removes tissue from benign prostatic hyperplasia (BPH) and leads to clinically relevant improvement in symptoms and quality of life as well as in micturition parameters and obstruction. Tissue is removed by high frequency (HF) current with synchronous hemostasis. Many modifications of TURP, such as the use of video, have become generally accepted and improved the standard. Other modifications were developed because the balance between cutting and hemostasis needed improvement in favor of hemostasis. Several modifications of TURP, such as modulation of HF pulses, band loops and bipolar resection and new procedures, such as vaporization and enucleation showed improved hemostasis. These modifications and procedures, however, have not yet replaced standard TURP but have become established as additional options.

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Der korrespondierende Autor gibt für sich und seine Koautoren an, dass kein Interessenkonflikt besteht.

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Correspondence to Prof. Dr. R. Muschter.

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Muschter, R., Bach, T. & Seitz, M. Transurethrale Resektion der Prostata und Modifikationen (bipolar, Elektrovaporisation). Urologe 52, 331–338 (2013). https://doi.org/10.1007/s00120-012-3088-y

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Schlüsselwörter

  • Resektion, bipolare
  • Prostatahyperplasie, benigne
  • Bandschlinge
  • Vaporisation
  • Enukleation

Keywords

  • Resection, bipolar
  • Prostatic hyperplasia, benign
  • Band loop
  • Vaporization
  • Enucleation