TRANSURETHRAL ELECTROVAPORIZATION OF THE PROSTATE - A POSSIBLE ALTERNATIVE TO TRANSURETHRAL RESECTION - A ONE-YEAR FOLLOW-UP OF A PROSPECTIVE RANDOMIZED TRIAL
My. Hammadeh et al., TRANSURETHRAL ELECTROVAPORIZATION OF THE PROSTATE - A POSSIBLE ALTERNATIVE TO TRANSURETHRAL RESECTION - A ONE-YEAR FOLLOW-UP OF A PROSPECTIVE RANDOMIZED TRIAL, British Journal of Urology, 81(5), 1998, pp. 721-725
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.