Photoselective potassium titanyl phosphate (KTP) laser vaporization versus transurethral resection of the prostate for prostates larger than 70 mL: a short-term prospective randomized trial.

Objectives: To compare the short term outcomes of photoselective vaporization (PVP) and transurethral resection of the prostate (TURP) for glands larger than 70 mL in a prospective randomized trial.

Methods: Seventy-six consecutive patients with enlarged prostatic adenomas of 70 to 100 mL were randomly assigned for surgical treatment with TURP (n = 37) or PVP (n = 39). International Prostate Symptom Score (IPSS), International Index of Erectile Function (IIEF-5) scores, maximum flow rates (Qmax), postvoid urine residues (PVR), and transrectal ultrasound (TRUS) volumes were recorded. Operative data, complications, catheter removal, and hospitalization periods were also recorded. Patients were reassessed at 3 and 6 months.

Results: Baseline characteristics of both groups were similar. Mean preoperative TRUS volume was 88 +/- 9.2 mL in the TURP group and 86.1 +/- 8.8 mL in the PVP group. The procedure was significantly shorter for the TURP group (51 +/- 17.2 minutes versus 87 +/- 18.3 minutes, P <0.05), catheter removal (3.9 +/- 1.2 days and 1.7 +/- 0.8 days, P <0.05), and hospital stay (4.8 +/- 1.2 days versus 2 +/- 0.7 days, P <0.05) were shorter in the PVP group. A significant difference in IPSS, Qmax and PVR values was observed within the follow-up period in favor of the TURP. The percentage volume reduction was significantly higher in TURP group. Reoperation was necessary in 7 patients in PVP but none in TURP group.

Conclusions: Although PVP offers advantageous over TURP with regard to intraoperative and perioperative safety, early functional results of TURP are superior to PVP in patients with enlarged prostates larger than 70 mL.