Electrovaporization of the Prostate versus Laser Ablation of the Prostate in Men with Benign Prostatic Hypertrophy:A Pressure-Flow Analysis

Abstract

Purpose: To urodynamically assess the outcome results in a prospective cohort study of electrovaporization of the prostate (TVP) versus laser ablation of the prostate (LAP) in men with benign prostatic hyperplasia (BPH). Materials and Methods: A randomized cohort of 10 men were enrolled to undergo a TVP procedure and a second cohort of 10 patients to undergo LAP. Preoperatively and at the 6-month follow-up all patients underwent a pressure-flow urodynamic study. Transrectal ultrasound for prostatic volume was performed at the time of enrollment and at the 6-month follow-up. Results: Preoperatively, all patients except 1 were in the obstructed or equivocal range according to the Abrams-Griffin nomogram. At the 6-month follow-up the mean maximum detrusor pressure (P_det) maximum flow rate (Q_max) for both groups of patients moved into the equivocal range. The mean prostatic volume for the TVP patients decreased 20% in comparison to a 2% decrease in prostatic volume for LAP patients. Both groups experienced similar decreases in the American Urological Association (AUA) symptom scores and increases in peak flow rates at the 6-month follow-up. Conclusion: Both treatment groups demonstrated a relief in symptoms by urodynamic assessment and AUA symptom score. This was present even though both groups had only a minimal decrease in prostatic volume. A reduction in prostate volume does not appear to be a prerequisite for improvement of symptoms from BPH.