A 3-year follow-up of a prospective randomized trial comparing transurethral electrovaporization of the prostate with standard transurethral prostatectomy

Objective To compare the safety, efficacy and durability of transurethral e lectrovaporization of the prostate (TUVP) with standard transurethral resec tion of the prostate (TURP). Patients and methods In all, 104 patients admitted from the waiting list fo r surgery for BPH were randomized to either TUVP (52 patients, mean age 67. 5 years) or TURP (52 patients, mean age 70.2 years); 51, 47 and 40 patients in each arm completed 1, 2 and 3 years of follow-up, respectively. Patient s were assessed at baseline and during the follow-up using the Internationa l Prostate Symptom Score (IPSS), the associated quality-of-life score (QoL) , postvoid residual volume (PVR) and maximum urinary flow rate (Q(max)). Results Both groups had comparable mean IPSS, QoL, Q(max) and PVR at baseli ne. The mean (sd) values for TUVP and TURP, respectively, at 3 years showed a significant and maintained improvement in IPSS, at 4.1 (3.3) and 7.1 (6. 2) (P = 0.01), in QoL, at 1.0 (0.9) and 1.6 (1.4) (P = 0.04), and in Q(max) , at 22.2 (8.5) and 18 (7.1) mL/s (P = 0.02), with decreases in PVR of 30 ( 38) and 21.9 (26.2) mL (P = 0.27). The re-operation rate in each group was 4% during the first year, 4% during the second year and 5% during the third year. After surgery and at 1, 2 and 3 years of follow-up, impotence was re ported in 17% of the TUVP group and 11% of the TURP group (P = 0.49), and r etrograde ejaculation in 72% of the TUVP group and 89% of the TURP group (P = 0.47). Conclusion The 3-year follow-up results confirm that TUVP is as effective a s standard TURP in the treatment of moderate-sized BPH. The long-term side- effects and complications were comparable and the initial improvement was m aintained over 3 years in most patients in both groups.