DOI: 10.4103/ua.ua_113_25 ISSN: 0974-7796

Corkscrew technique: A novel modification in transurethral resection of large prostate (60–100 g) optimizing resection efficacy and safety: A double-blind randomized controlled trial

Mohammed Aziz, Mohamed El-Shazly, Ammar Alorabi, Hossam Kandeel, Mohamed Farag Sultan
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Abstract

Introduction:

This study aimed to evaluate a novel modification of the conventional transurethral resection of the prostate (TURP) techniques, named Corkscrew, targeting optimization of resection efficiency and safety in prostates larger than 60 g.

Patients and Methods:

In this prospective, double-blind, randomized controlled study, 90 patients with benign prostatic hyperplasia (60–100 g) were allocated to undergo TURP via either Nesbit’s or Corkscrew technique. Our modification involved a clockwise resection starting at 3 o’clock zone-by-zone from the bladder neck to verumontanum in a corkscrew fashion with instant hemostasis. Outcomes assessed included resection time, resected weight, retrieval rate, complication rates, and postoperative changes in International Prostate Symptom Score (IPSS), maximum flowrate (Q-max), postvoid residual volume (PVR), and hemoglobin decrease.

Results:

Corkscrew group showed significantly shorter resection time ( P = 0.034), higher resected tissue weight ( P = 0.002), and superior tissue retrieval rate ( P < 0.001). Complications were mild and of lower rates (6.6% vs. 20%, P = 0.048). Postoperatively, both groups improved significantly in IPSS, Q-max, and PVR. However, PVR improvement was significantly more in Corkscrew group ( P < 0.001). Hemoglobin decrease was comparable and clinically insignificant.

Conclusion:

The Corkscrew technique is a novel, safe, and efficient alternative for large prostates. It demonstrated comparable outcomes to overall conventional bipolar TURP and superiority over Nesbit’s technique, particularly regarding resection time and retrieval rate.

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