A Short-term Comparative Study on Efficacy and Safety of Standard Transurethral Resection of the Prostate and Transurethral Electro-Vaporization of the Prostate

Kang, Yong Joo; Lee, Tae Hoon; Park, Young Ho

Abstract

PURPOSES: Transurethral resection of the prostate (TURP) for symptomatic benign prostate hyperplasia (BPH) remains a gold standard for surgical treatment, but significant morbidities are associated with the procedure. Transurethral electro-vaporization of prostate (TVP) using a grooved ball electrode, a modification of standard TURP, was tried on bladder outlet obstruction in an attempt to reduce the morbidity rate of TURP. We compared between the TVP and standard TURP to estimate the efficacy and safety.
MATERIALS AND METHODS
A comparative trial of 44 patients with symptomatic BPH from May 1995 to December 1995 was performed. Of the patients 20 were received operation with TVP (Group I) and 24 were received with standard TURP (Group II). Patients were assessed at baseline for both safety and efficacy and in follow-up at 1 and 3 months. Efficacy parameters evaluated included American Urological Association (AUA) symptom score, peak urine flow (Qmax) and postvoid residual urine (ml). Safety parameters evaluated included incidence of side effects, operative time (in minutes), postoperative catheterization time, change in hematocrit and serum sodium.
RESULTS
The mean age of each group was 63.7+-6.4 years (Group I) and 68.8+-7.6 years (Group II), the prostate size was 32.4+-3.4g and 34.5+-6.5g. The mean operation time was shorter in Group I (56+-11min) than Group II (85+-34min), (P<0.05). The change of Hematocrit(ml/dl) was lower in group I (from 41.1+-5.0 to 39.5+-4.2) than group II (from 39.6+-4.4 to 35.2+-5.5), (P<0.05). The mean catheterization time was 3.3+-1.3 days and 4.8+-1.7 days, (P<0.05). change of maximal flow rate, post-void residual volume and AUA symptom score was not significantly different between each group. The incidence of postoperative complications were not significantly different between each group.
CONCLUSIONS
Although the TURP is the gold standard for the treatment of symptomatic BPH with high success rate, but significant morbidities rate are associated with this procedure. So, TVP is new and potentially useful modification of TURP. In this preliminary study, there has been significant clinical improvement maintained with minimal morbidity. This early clinical experience highlights several potential advantages of TVP, including rapid convalescence time, short hospital day, and minimal blood loss. So, TVP is one of the various therapeutic alternatives for BPH lowering the morbidity rate of standard TURP.