MP62-12 THE 3 YEARS' TEST OF TIME IN LARGE PROSTATE SURGERY – BIPOLAR PLASMA VAPORIZATION, RESECTION AND ENUCLEATION VERSUS OPEN PROSTATECTOMY IN A PROSPECTIVE, RANDOMIZED-CONTROLLED CLINICAL SETTING

Abstract

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology I1 Apr 2018MP62-12 THE 3 YEARS' TEST OF TIME IN LARGE PROSTATE SURGERY – BIPOLAR PLASMA VAPORIZATION, RESECTION AND ENUCLEATION VERSUS OPEN PROSTATECTOMY IN A PROSPECTIVE, RANDOMIZED-CONTROLLED CLINICAL SETTING Bogdan Geavlete, Cosmin Ene, Catalin Bulai, Georgiana Balan, and Petrisor Geavlete Bogdan GeavleteBogdan Geavlete More articles by this author , Cosmin EneCosmin Ene More articles by this author , Catalin BulaiCatalin Bulai More articles by this author , Georgiana BalanGeorgiana Balan More articles by this author , and Petrisor GeavletePetrisor Geavlete More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.2013AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The study compared the transurethral resection in saline (TURis), transurethral vaporization in saline (TUVis), bipolar plasma enucleation of the prostate (BPEP), and open prostatectomy (OP) in a single center, prospective, randomized-controlled clinical setting exclusively involving severe lower urinary tract symptoms' large prostate patients. METHODS During a 4½ year enrollment period, 320 cases of prostate volume over 80 mL, maximum flow rate (Qmax) below 10 mL/second, International Prostate Symptom Score (IPSS) over 19 or urinary retention were included in the trial and equally randomized in the four study arms. Patients were assessed preoperatively, at the 1-, 3-, 6- and 12-month follow-up checkups and every 6 months up to 3 years after surgery using the IPSS, quality of life (QoL) score, Qmax, postvoiding residual urinary volume (PVR) and prostate-specific antigen (PSA). RESULTS Similar preoperative parameters were established in the four series. OP and BPEP were characterized by resembling operating times, while TURis and TUVis displayed prolonged surgical durations. TURis emphasized a substantially decreased mean resected tissue weight. TUVis showed the lowest mean hemoglobin level drop, followed by TURis and BPEP (equivalent results) and finally OP (highest bleeding). OP described the longest mean catheterization period and hospital stay, followed by TURis and afterwards by TUVis and BPEP (similar data). During the 3 years' follow-up period, statistically equivalent IPSS, QoL, Qmax and PVR outcomes were established for OP, BPEP, and TURis. TUVis displayed significantly smaller long term Qmax improvements but otherwise similar functional features. Significantly lower mean PSA levels were determined secondary to OP and BPEP when compared to bipolar resection and subsequently to vaporization up to the 36 months' postoperative assessment. CONCLUSIONS OP and BPEP emphasized the highest surgical efficiency (with prolonged postoperative recovery for open surgery), while TUVis displayed the lowest hemorrhagic risks. On the medium and long term, generally resembling functional outcomes were determined for the 4 techniques, with significantly decreased mean PSA values secondary to OP and BPEP. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e836-e837 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Bogdan Geavlete More articles by this author Cosmin Ene More articles by this author Catalin Bulai More articles by this author Georgiana Balan More articles by this author Petrisor Geavlete More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...