title: Transurethral photoselective vaporization versus transvesical open enucleation for prostatic adenomas >80ml: 12-mo results of a randomized prospective study.
abstract: OBJECTIVE
  To compare the effectiveness and the safety of photoselective vaporization of the prostate (PVP) to open prostatectomy (OP) for the surgical treatment of large prostatic adenomas.
  
  
  METHODS
  A total of 125 patients with prostate glands >80ml were randomly allocated to PVP (n=65) or OP (n=60) and prospectively evaluated at 1, 3, 6, and 12 mo postoperatively. International Prostate Symptom Score (IPSS) and peak urinary flow rate (Q(max)) were chosen as primary treatment-related end points.
  
  
  RESULTS
  The patients who underwent PVP experienced a longer length of operation time, shorter time of catheterization, and shorter hospital stay. Adverse events were minor and of similar profiles in both groups, although patients who underwent OP showed a higher transfusion rate. All functional parameters improved significantly compared to baseline values in both groups. The IPSS did not differ between the two groups at 3, 6, and 12 mo postoperatively. Patients who underwent OP scored better in the IPSS quality of life score at 6 and 12 mo postoperatively. No significant differences between the two groups in the Q(max), postvoid residual urine volume, and International Index for Erectile Function-5 questionnaire were detected. At 3 mo prostate volume was significantly lower in the OP group compared to the PVP group (median value 10ml vs. 50ml; p<0.001) and remained as such throughout follow-up, whereas prostate-specific antigen values reached statistical difference at 6 mo (median value 2ng/ml vs. 2.4ng/ml; p=0.028).
  
  
  CONCLUSIONS
  Our results indicate that for a 12-mo period PVP is a highly acceptable treatment alternative to OP.
authors: Athens Medical School, 2nd Department of Urology, Sismanoglio Hospital, Athens, Greece.
authors: Gerasimos
authors: G
authors: Alivizatos
authors: Andreas
authors: A
authors: Skolarikos
authors: Dimitrios
authors: D
authors: Chalikopoulos
authors: Christos
authors: C
authors: Papachristou
authors: Odysseas
authors: O
authors: Sopilidis
authors: Athanasios
authors: A
authors: Dellis
authors: Ioannis
authors: I
authors: Kastriotis
authors: Charalambos
authors: C
authors: Deliveliotis
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011468:Prostatectomy / Q000379:methods; D011470:Prostatic Hyperplasia / Q000473:pathology / Q000601:surgery*; D020728:Transurethral Resection of Prostate; D001743:Urinary Bladder