A COMPARATIVE-STUDY OF TRANSURETHRAL RESECTION OF THE PROSTATE USING A MODIFIED ELECTRO-VAPORIZING LOOP AND TRANSURETHRAL LASER VAPORIZATION OF THE PROSTATE

Purpose: We determined the relative efficacy of a modification of tran surethral resection of the prostate using a vaporizing loop (VaporTrod e) with transurethral laser vaporization of the prostate using the Ul traline dagger fiber. Materials and Methods: A comparative trial of 58 patients with symptomatic prostatism was performed. Parameters evalua ted included operative time, postoperative catheterization time, Ameri can Urological Association (AUA) symptom score, peak urine flow and po st-void residual urine. Results: Of the 29 patients who underwent elec tro-vaporization AUA symptom score decreased from 15.3 to 5.3 and 4.9, and peak urine flow increased from 8.2 to 14.9 ml. per second and 15. 6 ml. per second at 1 and 3 months, respectively (p = 0.01). Of the 29 patients undergoing laser vaporization of the prostate AUA symptom sc ore decreased from 14.7 to 10.1 and 7.6, and peak urine flow increased from 9.7 to 13.7 ml. per second and 14.9 ml. per second at 1 and 3 mo nths, respectively (p = 0.025). However, there were significant differ ences in mean catheterization time (electro-vaporization group 14.7 ho urs and laser group 79.6 hours, p <0.001), and cases of postoperative irritative symptoms (3 electro-vaporization and 19 laser) and retentio n requiring repeat catheterization (6 laser). Conclusions: Our early c linical experience highlights several potential advantages of electro- vaporization, particularly the low incidence of postoperative morbidit y. Currently a multicenter clinical trial is underway to determine the long-term efficacy and safety of electro-vaporization as a potential therapeutic modality in the treatment of men with symptomatic benign p rostatic hyperplasia.