Transurethral vaporization of the prostate: a promising new technique.
OBJECTIVE
To evaluate the efficacy and safety of transurethral electrovaporization of the prostate (TUVP), using a grooved roller electrode, for the surgical treatment of symptomatic benign prostatic hypertrophy (BPH).


METHODS
TUVP was carried out using a grooved roller electrode, pure-cutting diathermy and a standard irrigating resectoscope to rapidly heat prostatic tissue to > 100 degrees C, resulting in vaporization and cavitation of the prostatic adenoma. Over a 10 month period, 116 patients (mean age 69.8 years, range 51-93) with symptomatic BPH (confirmed by a symptom score, urinary flow rate and an ultrasonographic estimate of residual volume) were treated by TUVP. Patients with carcinoma of the prostate, an elevated level of prostate-specific antigen or those in chronic urinary retention were excluded from the study. Each patient was followed up every 4 months during the first post-operative year, assessing their flow rate, residual volume and symptom score.


RESULTS
Symptom scores improved by 67% and residual volumes by 72%; the mean maximal flow rate increased from 8.5 mL/s (range 3.5-14) before treatment to 20.5 mL/s (range 4.5-39.0) at the same 4 month review. The procedure was simple and safe, with a mean operative duration of 35 min (range 20-65), and no patients required a blood transfusion. Most patients had their catheters removed within 24 h and were discharged on the second day after treatment.


CONCLUSIONS
The effectiveness of TUVP in improving symptoms and flow rates in patients with BPH was established. With minimal capital expenditure and a reduced in-patient stay. TUVP appears to have several advantages over other surgical treatments for BPH, although continued follow-up is needed to establish the long-term results.
Thomas
K J
KJ
Department of Urology, University Hospital of Wales, Cardiff, UK.
Cornaby
A J
AJ
Hammadeh
M
M
Philp
T
T
Matthews
P N
PN
D000368:Aged; D000369:Aged, 80 and over; D004598:Electrosurgery / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011468:Prostatectomy / Q000379:methods; D011470:Prostatic Hyperplasia / Q000503:physiopathology / Q000601:surgery*; D012735:Sexual Dysfunction, Physiological / Q000209:etiology; D016896:Treatment Outcome; D016055:Urinary Retention / Q000209:etiology / Q000601:surgery; D014554:Urination