Transurethral resection (TUR) in saline plasma vaporization of the prostate vs standard TUR of the prostate: 'the better choice' in benign prostatic hyperplasia?

Objective: To evaluate the efficiency, safety and short-term outcome of transurethral resection in saline plasma vaporization of the prostate (TURis-PVP), and to compare it to the standard TUR of the prostate (TURP).

Patients And Methods: In all, 155 patients with benign prostatic enlargement (BPE) secondary to benign prostatic hyperplasia (BPH), with a maximum urinary flow rate (Q(max) ) of <10 mL/s, an International Prostate Symptom Score (IPSS) of >19 and prostate volume of 30-80 mL were enrolled in this prospective, randomized trial. All patients were evaluated preoperatively and at 1, 3 and 6 months after surgery by IPSS, health-related quality of life (HRQL) score, Q(max) and postvoid residual urine volume (PVR).

Results: Patients from both series had similar preoperative characteristics. TURis-PVP and TURP were successfully performed in all cases (75 and 80, respectively). The operative duration, catheterization period and hospital stay were significantly shorter for TURis-PVP patients at 35.1 vs 50.4 min, 23.8 vs 71.2 and 47.6 vs 93.1 h, respectively (all P < 0.05). At the 1, 3 and 6 months follow-ups, improvements in the variables measured were better in the TURis-PVP group: the IPSS was 4.4 vs 8.3 and the Q(max) was 22.7 vs 20.5 mL/s at 1 month; the IPSS was 4.8 vs 8.6 and the Q(max) was 22.3 vs 20.0 mL/s at 3 months; and the IPSS was 5 vs 9.1 and the Q(max) was 21.8 vs 19.3 mL/s at 6 months (All P < 0.05).

Conclusions: TURis-PVP represents a valuable endoscopic treatment alternative for patients with BPE, with superior efficacy, short-term results and complication rates compared with monopolar TURP.