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document
A prospective randomized study of transurethral resection of the prostate and transurethral vaporization of the prostate as a therapeutic alternative in the management of men with BPH . OBJECTIVE The common goals of new surgical treatment for benign prostatic hyperplasia ( BPH ) are to improve subjective and objective symptoms , to decrease the risk of postoperative complications and short hospitalization . Transurethral electrovaporization of the prostate ( TUVP ) is a new , minimally invasive and a promising alternative to standard transurethral resection of the prostate ( TURP ) in the treatment of BPH . The aim of this study is to compare the efficacy and safety of these two treatment alternatives . METHODS A prospective randomized trial of 60 patients with symptomatic BPH was performed . Preoperative and postoperative International Prostate Symptom Score ( IPSS ) , maximum flow rates ( Qmax ) and complications were recorded in each patient . The volume of the prostate was measured preoperatively and postoperatively using transrectal ultrasound . RESULTS Of the 30 patients who underwent TURP , mean hospital stay was 4.5 days . The Foley catheter was removed on postoperative day 4 following surgery . IPSS decreased from 21.6 to 5.2 , Qmax increased from 9.2 to 19.2 ml/s at 3 months . Mean prostatic volume at 3 months decreased from 51.7 to 26.2 g , a 49.3 % reduction . Of 30 patients undergoing TUVP , mean hospital stay was 2.5 days and the catheter was removed within 2 days following surgery . Postoperative urinary retention did not occur in any patient . IPSS decreased from 19.4 to 4.1 and Qmax increased from 7.9 to 17.7 ml/s at 3 months . Mean prostatic volume decreased from 48.9 to 27.8 g , a 43.1 % reduction at 3 months . In the TUVP group , none of the patients required blood transfusions or developed clinical transurethral resection syndrome . There were no major complications . Sphincteric incontinence , urethral strictures or bladder neck contractures were not recorded . At 3 months postoperatively , 13 patients in the TURP group and 7 patients in the TUVP group had retrograde ejaculation . CONCLUSION Our initial experience of TUVP suggests advantages over conventional TURP through reduced blood loss and shorter hospital stay . It appears to be an effective treatment for BPH ; however , long-term results should be evaluated .
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Intervention_Surgical
transurethral resection of the prostate and transurethral vaporization of the prostate
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Intervention_Surgical
Transurethral electrovaporization of the prostate ( TUVP )
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Intervention_Surgical
standard transurethral resection of the prostate ( TURP )
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Outcome_Physical
benign prostatic hyperplasia
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Outcome_Adverse-effects
postoperative complications
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Outcome_Other
efficacy and safety
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Outcome_Physical
Preoperative and postoperative International Prostate Symptom Score ( IPSS ) , maximum flow rates ( Qmax )
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Outcome_Adverse-effects
complications
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Outcome_Other
transrectal ultrasound
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Outcome_Other
Foley catheter
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Outcome_Physical
IPSS
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Outcome_Physical
Mean prostatic volume
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Outcome_Physical
Postoperative urinary retention
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Outcome_Physical
IPSS
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Outcome_Physical
Mean prostatic volume
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Outcome_Physical
blood transfusions
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Outcome_Physical
clinical transurethral resection syndrome
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Outcome_Adverse-effects
no major complications
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Outcome_Adverse-effects
Sphincteric incontinence
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Outcome_Adverse-effects
urethral strictures
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Outcome_Adverse-effects
bladder neck contractures
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Outcome_Physical
retrograde ejaculation
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Outcome_Physical
reduced blood loss
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Outcome_Other
shorter hospital stay
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Participant_Condition
men with BPH .