2264 BIPOLAR PLASMA VAPORIZATION VERSUS MONOPOLAR AND BIPOLAR TURP &endash; RESULTS OF A PROSPECTIVE, RANDOMIZED, LONG-TERM COMPARISON

Abstract

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy and New Technology1 Apr 20112264 BIPOLAR PLASMA VAPORIZATION VERSUS MONOPOLAR AND BIPOLAR TURP &endash; RESULTS OF A PROSPECTIVE, RANDOMIZED, LONG-TERM COMPARISON Bogdan Geavlete, Razvan Multescu, Florin Stanescu, Dragos Georgescu, Marian Jecu, and Petrisor Geavlete Bogdan GeavleteBogdan Geavlete Bucharest, Romania More articles by this author , Razvan MultescuRazvan Multescu Bucharest, Romania More articles by this author , Florin StanescuFlorin Stanescu Bucharest, Romania More articles by this author , Dragos GeorgescuDragos Georgescu Bucharest, Romania More articles by this author , Marian JecuMarian Jecu Bucharest, Romania More articles by this author , and Petrisor GeavletePetrisor Geavlete Bucharest, Romania More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.2507AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES This study aimed to evaluate a prospective, long term, randomized comparison between the bipolar plasma vaporization (BPV), monopolar and bipolar transurethral resection of the prostate (TURP) with regard to surgical efficacy, complication rate and follow-up results. METHODS A total of 510 patients with benign prostatic hyperplasia (BPH), Qmax < 10 ml/s, IPSS > 19 and prostate volume between 30 and 80 ml were enrolled in the trial. All cases were evaluated preoperatively and at 1, 3, 6, 12 and 18 months after surgery by International Prostate Symptom Score (IPSS), quality of life score (QoL), maximum flow rate (Qmax) and post-voiding residual urinary volume (RV). RESULTS Each study arm including 170 cases emphasized similar preoperative parameters. The operation time was significantly shorter for BPV patients and similar in the other study arms (39.7 versus 52.1 and 56.3 minutes), while the catheterization period and hospital stay were reduced for BPV, followed by bipolar and monopolar TURP (23.5 versus 46.3 and 72.8 hours; 46.9 versus 73.0 and 95.4 hours). The mean hemoglobin drop, intraoperative bleeding and the capsular perforation rate were significantly reduced in the BPV series by comparison to the bipolar and monopolar TURP study arms (0.5 versus 1.2 and 1.6 g/dl; 1.8% versus 8.2% and 13.5%; 1.2% versus 7.1% and 9.4%). The postoperative hematuria and blood transfusion rates were higher in the monopolar TURP group. The rate of irritative symptoms was similar in the 3 study arms (12.4% versus 11.2% and 10.6%). During the 1, 3, 6, 12 and 18 months follow-up, the BPV group emphasized significantly superior parameters in terms of IPSS, QoL and Qmax. The mean RV, PSA level and prostate volume decrease were similar in the 3 series. The bladder neck sclerosis and re-treatment rates were significantly reduced in the BPV group (2.4% versus 5.9% and 6.5%; 1.8% versus 4.7% and 5.3%). CONCLUSIONS BPV represents a valuable endoscopic treatment alternative for BPH patients, with superior efficacy and satisfactory complication rate. The long term follow-up emphasized durable improvements in terms of postoperative parameters for BPV, with significant progresses by comparison to monopolar and bipolar TURP. BPVP Bipolar TURP Monopolar TURP IPSS 1 month 4.6 7.2 7.2 3 month 4.3 7.1 7.5 6 month 4.2 7.3 7.6 12 month 4.5 7.5 8.0 18 month 5.0 7.9 8.3 Qmax (ml/s) 1 month 24.8 21.7 20.9 3 month 24.9 21.6 20.8 6 month 24.5 21.4 20.6 12 month 24.0 21.1 20.3 18 month 23.7 20.6 20.2 © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e907-e908 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Bogdan Geavlete Bucharest, Romania More articles by this author Razvan Multescu Bucharest, Romania More articles by this author Florin Stanescu Bucharest, Romania More articles by this author Dragos Georgescu Bucharest, Romania More articles by this author Marian Jecu Bucharest, Romania More articles by this author Petrisor Geavlete Bucharest, Romania More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...