MP02-02 PURE BIPOLAR PLASMA VAPORIZATION OF THE PROSTATE: 5-YEAR FOLLOW-UP FROM A PROSPECTIVE 3D ULTRASOUND VOLUMETRY STUDY

Abstract

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology I1 Apr 2017MP02-02 PURE BIPOLAR PLASMA VAPORIZATION OF THE PROSTATE: 5-YEAR FOLLOW-UP FROM A PROSPECTIVE 3D ULTRASOUND VOLUMETRY STUDY Benedikt Kranzbühler, Oliver Gross, Christian D. Fankhauser, Marian S. Wettstein, Nico C. Grossmann, Etienne X. Keller, Daniel Eberli, Tullio Sulser, Cédric Poyet, and Thomas Hermanns Benedikt KranzbühlerBenedikt Kranzbühler More articles by this author , Oliver GrossOliver Gross More articles by this author , Christian D. FankhauserChristian D. Fankhauser More articles by this author , Marian S. WettsteinMarian S. Wettstein More articles by this author , Nico C. GrossmannNico C. Grossmann More articles by this author , Etienne X. KellerEtienne X. Keller More articles by this author , Daniel EberliDaniel Eberli More articles by this author , Tullio SulserTullio Sulser More articles by this author , Cédric PoyetCédric Poyet More articles by this author , and Thomas HermannsThomas Hermanns More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.098AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Pure bipolar plasma vaporization (BPV) has been established as low-morbidity alternative to conventional transurethral resection of the prostate (TURP). Low intra- and postoperative morbidity as well as excellent functional short-term results have been reported. However, long-term outcome is still lacking. The extent of prostate tissue removal, which impacts the durability of postoperative functional improvements, is also unknown after BPV. The aim of the present study was to investigate the long-term functional outcome and associated prostate volume changes following pure BPV of the prostate. METHODS A consecutive series of 75 patients treated by pure BPV in a tertiary care academic center was prospectively investigated. Prostate volume was assessed using planimetric volumetry following transrectal 3D-ultrasound of the prostate. Prostate volume and clinical parameters were recorded preoperatively and regularly after BPV (after catheter removal, 6W, 6M, 1, 3 and 5Y). RESULTS Median (interquartile range; IQR) preoperative prostate volume was 41 ml (26.8ml), IPSS 16 (10), QoL 4 (2), Qmax 10.1ml/s (8ml/s), PVR 91ml (140ml) and PSA 2.57ng/ml (3.5ng/ml). A significant relative prostate volume reduction (RVR) of 33.3% (IQR: 22.3%; p<0.001) was already detectable at the time of catheter removal. Relative volume reduction increased significantly up to 12M (6W: 45.9% (17.4%; p<0.001), 6M: 50.5% (16.1%; p<0.001) and 12M 52.2% (17.4%; p=0.014). After 12M the RVR remained stable with 50.6% (14.3%; p=0.58) after 3Y and 52.6% (14.1%; p=0.59) after 5Y. Postoperatively, all investigated clinical parameters improved significantly and remained stable during the 5Y follow-up [5Y results (IQR): IPSS: 3 (8), QoL: 1 (1), Qmax: 16.3ml/s (13.7ml/s), PVR 20ml (46.5ml)]. Median PSA reduction after 5Y was 55% (36.2%). During the observation period 9 urethral strictures (12%) were detected of which 7 were de novo strictures. Bladder neck incisions for postoperative bladder neck stenosis were performed in 6 patients (8%). Median prostate volume in these patients was 30.6ml (18.2ml). Re-resections for re-grown adenoma were not necessary. CONCLUSIONS Low intra- and postoperative morbidity in combination with excellent functional outcome and durable prostate volume reduction confirm the role of contemporary BPV as a minimally invasive alternative to conventional TURP. However, postoperative bladder neck stenoses appeared rather frequent after BPV and might be a procedure-specific drawback. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e10 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Benedikt Kranzbühler More articles by this author Oliver Gross More articles by this author Christian D. Fankhauser More articles by this author Marian S. Wettstein More articles by this author Nico C. Grossmann More articles by this author Etienne X. Keller More articles by this author Daniel Eberli More articles by this author Tullio Sulser More articles by this author Cédric Poyet More articles by this author Thomas Hermanns More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...