TRANSURETHRAL ELECTROVAPORIZATION OF THE PROSTATE - A POSSIBLE ALTERNATIVE TO TRANSURETHRAL RESECTION - A ONE-YEAR FOLLOW-UP OF A PROSPECTIVE RANDOMIZED TRIAL

Objective To compare the efficacy, safety and durability of transureth ral electrovaporization of the prostate (TUVP) with standard transuret hral resection (TURP) in a prospective randomized trial. Patients and methods The study included 104 consecutive men with symptomatic benign prostatic hyperplasia (BPH) admitted for surgery who were randomized to TUVP or TURF, The variables evaluated included the duration of surg ery, catheterization and hospital stay, the International Prostate Sym ptom Score (IPSS), a quality-of-life assessment (QOL), the maximum uri nary flow rate (Q(max)) and the postvoid residual urine volume (PVR). Results Both groups showed a comparable significant and maintained dec line in the mean IPSS, from 26.5 to 4.4 (TUVP) and from 26.6 to 5.9 (T URP), and increase in mean Q(max), from 8.9 to 22.5 mL/s (TUVP) and 8. 6 to 22.8 mL/s (TURP) after 1 year. However, there were significant di fferences in the mean duration of catheterization (TUVP 20.9 h, TURF 4 6.6 h, P<0.001), hospital stay (TUVP 2.2 day, TURF 3.1 days, P<0.001), and the duration and volume of post-operative irrigation (TUVP none, TURF 18.1 h with 17.5 L of saline). Two patients in each group develop ed urethral strictures (4%) and two patients in each group required re -operation for residual adenoma (4%); two patients undergoing TURF had a bladder neck stricture (4%). Conclusion The results suggest that TU VP is as effective as standard TURF in the treatment of moderate-sized BPH. TUVP offers the advantage of using established instruments, has excellent peri-operative haemostasis and requires a shorter hospital s tay.