Combined transurethral resection and vaporization of the prostate using newly designed electrode: A promising treatment alternative for benign prostatic hyperplasia

Background and Objective: Postoperative irritative symptoms and lack of tis sue samples for histologic examination are the two main disadvantages of tr ansurethral electrovaporization of the prostate. To decrease the postoperat ive irritative symptoms while minimizing intraoperative and postoperative b leeding and also to obtain tissue samples, we have combined the techniques of transurethral resection and vaporization, a procedure we have termed Vap or-cut, by using the Wolf Wing gold-plated electrode. Patients and Methods: Forty-eight patients with symptomatic benign prostati c hyperplasia (BPH) were enrolled in the study. Adverse events during the p rocedure, including serial changes in both serum hematocrit and sodium, and postoperative irritative symptoms were recorded after removal of the ureth ral catheter. Preoperative and postoperative symptom scores and maximum flo w rates (Q(max)) were obtained in each patient. The volume of the prostate was measured preoperatively and postoperatively using transrectal ultrasono graphy. Results: During the procedure, there was minimal bleeding, and serum sodium and hematocrit levels were not changed significantly. The mean operative t ime was 49.3 minutes. The catheterization time and hospital stay were 48 an d 60 hours, respectively. Only five patients (10%) reported transient and i ntermittent postoperative hematuria lasting for 1 week. After removal of th e urethral catheter, four patients (8%) had irritative voiding symptoms. No patients experienced postoperative urinary retention or required subsequen t catheterization, At 3-month follow-up, the improvement in the mean Q(max) was 114%, and the decrease in the symptom score was 72%. The average reduc tion in the weight of the prostate was 55%. Conclusion: Vapor-cut of the prostate appears to be a safe, effective alter native to the standard loop resection and vaporization. It has the advantag es of minimal blood loss, excellent operative visibility, decreased postope rative irritative symptoms, and availability of tissue samples with short c atheterization and hospitalization times.