A RANDOMIZED PROSPECTIVE-STUDY OF TRANSURETHRAL ELECTROVAPORIZATION VS LASER-ABLATION OF THE PROSTATE IN MEN WITH BENIGN PROSTATIC HYPERTROPHY

Objective. A prospective randomized study comparing transurethral elec trovaporization (TVP) vs laser ablation of the prostate was undertaken to compare the efficacy and safety of the procedures. Methods. A tota l of 31 patients underwent treatment, with 20 patients receiving elect rovaporization sugrery and 11 patients undergoing laser treatment. Pat ients underwent initial evaluation consisting of an American Urologica l Association (AUA) symptom score, prostate specific antigen (PSA), ur oflowometry, pressure flow, and transrectal ultrasound for prostate vo lume. Patients were seen in follow-up at 1, 3 and 6 months. Results. A total of 3 1 patients with a 2:1 randomization of TVP to laser treatm ent were enrolled. The laser patients had a mean pre-operative AUA sym ptom score of 19.0 and scores of 9.0, 6.0 and 5.0 at 1, 3- and ti-mont h follow-up. The TVP patients had a mean pre-operative symptom score o f 22.0 and scores of 7.0, 8.0 and 5.0 at 1-, 3- and 6-month follow-up. Mean peak uroflow (PF) rate pre-operative was 10.7 for the laser grou p and 7.7 for the TVP group. At 1-, 3- and 6-month follow-up, mean PF rates of 13.3, 17.6 and 16.5 were present for the laser patients and 1 5.0, 17.5 and 14.2 for the TVP group. The differences were not statist ically significant. There were 6 complications in the laser patients a nd 7 complications in the TVP group. Operative time was a mean of 27 m in for the laser patients and 46 min for the TVP group. and the differ ence in operative time was statistically significant. Conclusion. At 6 -month follow-up the improvement in symptoms score and peak flow rate are comparable in both treatment groups. The electrovaporization proce dure required significantly longer to perform than the laser procedure . Long-term follow-up is required to see if these results remain susta inable for electrovaporization therapy.