Prospective Study To Establish Correlation Between Maximum Rise In Rectal Temperature And Minimum Effective Power For Vapourization During TUEVP In BPH And Its Effect On Post Operative Results

Shivam Singh; Kartik Saxena; Nishi Gupta; Desai Sandipkumar Vallabhbhai; Shekhar Shivam; Rijul Saini; Gourav S. Makkar

Volume : VIII, Issue : II, February - 2018

Prospective Study To Establish Correlation Between Maximum Rise In Rectal Temperature And Minimum Effective Power For Vapourization During TUEVP In BPH And Its Effect On Post Operative Results

Shivam Singh, Kartik Saxena, Nishi Gupta, Desai Sandipkumar Vallabhbhai, Shekhar Shivam, Rijul Saini, Gourav S. Makkar

Abstract :

BACKGROUND

Out of the Various Surgical Management Techniques For Benign Prostatic Hyperplasia, Transurethral Electrovapourization of Prostate is a Minimal invasive procedure comparable to Transurethral Resection of Prostate which removes prostatic tissue by using High Vapourization Power , combining the effects of Vapourization and Dessication.

The Study Aims to Establish the Co–relation between the Maximum Rise in Rectal Temperature and Minimum Effective Power for Vapourization used during TUEVP and its Effect on Post Operative Results, thus helping us to have an idea about the effect of lateral thermal damage at high energy levels during TUEVP.

METHODS

The Prospective Study was Conducted on 60 Patients of Benign Prostatic Hyperplasia at SGMH, New Delhi. Continous Rectal temperature monitoring was done during TUEVP and Maximum Rise in Rectal temperature was noted at different Vapourization Powers. Patients post operative results were assessed on basis of IPSS and QOL index and complications if any were noted with a follow up of 3 months . Results were compared with the Vapourization power (150–300 Watt) used along with Maximum Rise in Rectal Temperature.

RESULTS

The Mean of Maximum Rise in Rectal Temperature was .5^oC at 160 MEPV, 1.005^oC at 180 MEPV, .4^oC at 190 MEPV and 1.52^oC at 200 MEPV. At MEPV of 220 , 240 ,260 and 280 Watts, the Mean of Maximum Rise in Rectal Temperature was 2.2^o, 2.4^o , 2.55^oand 2.8^o Celsius , respectively.

At 160 MEPV, there was no complications. At 180 MEPV, 96.87% had no complications while 3.12% of patients had Clot retention. At 190 and 200 MEPV, there were no complications. At 220 MEPV, 25% patients had Clot retention. At 240 MEPV 66.67% had no complications while 33.33% of patients had Clot Retention. At 260 MEPV , 50% of patients had Retrograde ejaculation .At 280 MEPV only 1 patient was operated which developed Clot retention (100%).

CONCLUSION

This study had established that there was a significant direct correlation between Minimum Effective Power for Vapourization and Rectal Temperature During TUEVP and no siginificant difference in IPSS improvement, QOL improvement and Complications rate.

It showed that at all MEPV Levels , TUEVP was equally efficacious and safe. Only very minor complications occurred which mostly could be tackled immediately.