Thick Loop Transurethral Resection of the Prostate

Objectives: To evaluate the safety and efficacy of the new resection loops for transurethral resection of the prostate (TURP). These loops, which are both thicker and have a modified shape, allow simultaneous resection, increased tissue vaporization, and improved hemostasis. Methods: Two open studies have been performed with the thick resection loop. In one series, 91 patients underwent TURP with the Vapor Cut (G. Vallancien, Paris), and in another series, 65 patients underwent Wedge (Microvasive, Natick, Mass., USA) resection (A. Perlmutter, New York). Results: At 1 year follow-up, patients who underwent thick loop resection enjoyed the same clinical benefit of thin loop TURP without additional morbidity. Peak urinary flow rate improved to 18.4 and 16.3 cm 3 /s at 1 year with the Vapor Cut and Wedge, respectively. IPSS fell to 7.2 (Vapor Cut) and 6.2 (Wedge). Postoperative bleeding, meatal stenosis, and urethral stricture were noted, but no impotence or incontinence was observed. Conclusions: Thick loop resection offers the advantage of improved surgical vision during resection, thus allowing a more accurate and safer resection. This can be performed with only minor modifications of the standard TURP technique.