Clinical outcome 1 year after transurethral vaporization and resection of the prostate

Abstract

Objectives: To evaluate the 1-year safety and effectiveness of transurethral vaporization of the prostate (TUVP) compared with transurethral resection of the prostate (TURP) in alleviating outflow obstruction. Methods: Two experienced surgeons performed 26 TUVPs and 28 TURPs. The intraoperative blood loss was measured by photometry and fluid absorption by the ethanol method. The treatments were evaluated by means of the International Prostate Symptom Score (IPSS), quality-of-life score, transrectal ultrasound, prostate-specific antigen level, urinary flow rate, and postvoid residual urine volume. Results: After TUVP, the median IPSS decreased from 22 to 4.5 and the quality-of-life score from 4.5 to 1.5. The corresponding data for TURP were from 25 to 5.5 and from 4.0 to 1.0. The median urinary flow rate increased from 4 to 10 mL/s after TUVP and from 2 to 11 mL/s after TURP. The postvoid residual urine volume decreased to 35% (TUVP) and 15% (TURP) of the preoperative volume. The blood loss was larger during TURP ( P <0.04), but complications during follow-up were more frequent after TUVP ( P <0.02). Patients with fluid absorption during surgery had a lower quality-of-life score at follow-up ( P <0.02) and tended to have a smaller reduction in prostate size (to 79%) than those without absorption (to 67% of baseline). Conclusions: TUVP and TURP were both effective in alleviating outflow obstruction, but the outcome appeared to be slightly better for TURP.