Is transurethral vaporization a remake of transurethral resection of the prostate?
OBJECTIVE
Transurethral resection of the prostate (TURP) is still the gold standard method to treat benign prostatic hyperplasia (BPH). Transurethral vaporization of the prostate (TUVP) is compared with the transurethral resection of benign prostatic hyperplasia.


METHODS
Over a 10-month period, 78 patients presenting with moderate and severe symptomatic BPH were randomized into two groups. A total of 38 patients underwent TURP, and 40 men underwent TUVP. The protocol included urinary flow rate (Qmax), symptomatology evaluated by the International Prostatic Symptom Score (I-PSS), and an ultrasonographic estimate of the postvoiding residual volume (PVR). The TUVP was carried out using a regular loop with the electrical source set at 250 to 300 W in the pure cutting mode. The same technique was used in the TURP, but the electrosurgical unit was set at 50 to 80 W for cutting and 50 W for hemostasis. The mean follow-up was 17 months (range 11-23 months).


RESULTS
The data showed significant improvement in the symptom score, maximum flow rate, and postvoiding residual urine volume after treatment (P<0.01) in both groups. Comparing the symptom score, there was no difference between the two techniques (P = 0.88), the same occurring with the PVR (P = 0.78). However, the Qmax was higher after TURP (P = 0.02). The amount of tissue resected showed no statistical difference between the two techniques (P>0.05). Operative time, postoperative irrigation, catheter removal, and hospital stay were better with TUVP (P = 0.001). There was a statistically significant difference (P = 0.003) when we compared the occurrence of retrograde ejaculation with TURP (32%) and TUVP (65%) The TUVP using a regular loop, in addition to the advantage of the equipment and technique already being familiar to urologists, is efficient and reduces capital expenditure.


CONCLUSIONS
The TUVP is a remake of TURP, with higher energy offering better results.
Netto
N R
NR
Division of Urology, University of Campinas Medical Center, Unicamp, São Paulo, Brazil. rodrigues.netto@u-netsys.com.br
De Lima
M L
ML
Lucena
R
R
Lavoura
N S
NS
Cortado
P L
PL
Netto
M R
MR
D000368:Aged; D000369:Aged, 80 and over; D004598:Electrosurgery; D004724:Endoscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011470:Prostatic Hyperplasia / Q000000981:diagnostic imaging / Q000601:surgery*; D020728:Transurethral Resection of Prostate / Q000379:methods*; D016896:Treatment Outcome; D014463:Ultrasonography; D014563:Urodynamics; D014835:Volatilization