TRANSURETHRAL ELECTROVAPORIZATION OF THE PROSTATE VERSUS TRANSURETHRAL PROSTATIC RESECTION - A COMPARISON OF POSTOPERATIVE HEMORRHAGE

Objectives. To determine the acute and delayed hemorrhage rate of tran surethral electrovaporization of the prostate (TEVP) versus standard t ransurethral resection of the prostate (TURF). Methods. A retrospectiv e review of 524 consecutive patients who underwent TURF and 302 consec utive patients who underwent TEVP was conducted. The indications for b oth procedures were identical and based on history, physical examinati on, American Urological Association symptom score, and uroflowmetry. P arameters of evaluation included the incidence of both initial and del ayed hemorrhages, the time until a delayed bleed occurred, blood trans fusion rates, and the average length of stay in hospital after a bleed . Results. The overall hemorrhage rate for TUFF and TEVP was 4.8% and 4.0%, respectively. In the TURF group, there was a 1.1% incidence of a cute bleeds and 3.6% incidence of delayed bleeds. For the TEVP group, 0.3% had an acute hemorrhage, and 3.6% were readmitted for clot retent ion. The average length of time from original discharge to readmission was 12.9 days for the TUFF group with a mean repeat stay of 5.7 days. For the TEVP group, the average interval to readmission was 15.4 days with a stay of 3.1 days. Conclusions. The overall rate of hemorrhage for the TEVP group was slightly lower than for the TURF group due to f ewer acute bleeds. However, the incidence of delayed bleeds and clot r etention between the two was identical at 3.6%. Because of improved he mostasis intraoperatively with similar functional results in the long term as shown by other investigators, we foresee TEVP continuing as a viable alternative to TURF. (C) 1998, Elsevier Science Inc. All rights reserved.