Gyrus TM bipolar electrovaporization vs transurethral resection of the prostate: a randomized prospective single-blind trial with 1 y follow-up WD Dunsmuir 1 *, JP McFarlane 1 , A Tan 1 , C Dowling 1 , J Downie 1 , J Kourambas 1 , S Donnellan 1 , N Redgrave 1 , R Fletcher 1 , M Frydenberg 2 & C Love 1 1 Department of Urology, Monash Medical Centre, Melbourne, Australia; and 2 Department of Surgery, University of Monash, Victoria, Australia The Gyrus TM system uses bipolar electrocautery with saline irrigation to vaporize prostatic tissue and is compared to transurethral resection of the prostate (TURP) in a randomized prospective study with 1 y follow-up. Outcomes measured were fluid absorption, blood loss, period of catheterization, hospital stay, symptom scores, quality of life, flow rates, and post-void residual volumes at 3, 6, and 12 months. All measured parameters were similar, although re-catheterization rates were higher (30% vs 5%) in the Gyrus group. Clot evacuation rates were higher in the TURP group (19% vs 0%). The Gyrus TM device is safe and produces results that are similar to TURP at 1y. Prostate Cancer and Prostatic Diseases (2003) 6, 182–186. doi:10.1038/sj.pcan.4500631 Keywords: Gyrus TM ; electrovaporization; prostate; TURP; randomized-controlled trial Introduction Transurethral resection of the prostate (TURP) is cur- rently the most frequently performed operation for men with lower urinary tract symptoms (LUTS) thought to be secondary to benign prostatic hypertrophy (BPH). How- ever, perioperative electrolyte disturbances (TUR syn- drome) and haemorrhage are recognized complications. 1 Furthermore, TURP systems utilize monopolar electrical currents that can cause nervous stimulation and, in rare circumstances, burns and problems with cardiac pace- makers. In addition, monopolar systems are not efficient for simultaneously cutting and coagulating prostatic tissue. The Gyrus TM device has recently been shown to be an effective and safe system. 2 This instrument creates a cavity in the prostate similar to that achieved with the conventional resectoscope. The system uses bipolar currents that have several possible advantages. First, the prostatic ablation is performed using saline irrigation minimizing the electrolyte problems that are frequently recognized with glycine, mannitol, and water systems. 3 Second, the absence of a return current removes the risks of nervous stimulation, burns, and cardiac pacemaker problems. Third, the ability to improve the ‘coupling’ of the cut and coagulation modes may result in less haemorrhage. As such, the operative procedure may be technically easier and the need for postoperative irrigation reduced. In turn, recovery may be quicker and hospital stays shorter than with conventional TURP. However, to date, no randomized trials evaluating these aspects of the surgi- cal procedures have been reported. The aim of this study was to compare the Gyrus TM system with TURP. The outcomes measured were perioperative bleeding and electrolyte changes, length of time for postoperative catheterization and hospital stay. Efficacies in terms of symptom improvement, flow rates, and postvoid Received 26 June 2002; revised 9 August 2002; accepted 14 August 2002 *Correspondence: WD Dunsmuir, 34 Stubbs Lane, Lower Kingwood, Surrey KT20 7AS, UK. E-mail: billydunsmuir@btinternet.com Prostate Cancer and Prostatic Diseases (2003) 6, 182–186 & 2003 Nature Publishing Group All rights reserved 1365-7852/03 $25.00 www.nature.com/pcan