Objective: To assess the efficacy and safety of transurethral resection in saline vaporization for symptomatic bladder outlet obstruction and the change in prostate volume.

Methods: A total of 106 patients with symptomatic bladder outlet obstruction underwent transurethral resection in saline vaporization. The effectiveness of the treatment was evaluated using the International Prostate Symptom Score (IPSS), quality of life score, urinary peak flow, and prostate volume preoperatively and at 1, 3, 6, and 12 months postoperatively. To assess the treatment effect, the patients were divided into 3 groups according to the preoperative prostate volume: group 1 (<45 cm(3), n = 40), group 2 (≥ 45 but <65 cm(3), n = 34), and group 3 (≥ 65 cm(3), n = 32).

Results: The mean perioperative hemoglobin loss was 1.2 g/dL. The mean IPSS, quality of life score, and prostate volume decreased significantly from 24.3, 5.2, and 52.8 cm(3) to 11.1, 2.7, and 29.9 cm(3), respectively (P < .01) and the mean urinary peak flow had increased significantly from 7.3 to 15.1 (P < .01) at 1 month. Moreover, the IPSS, quality of life score, and prostate volume had significantly decreased to 8.8, 2.3, and 26.1 cm(3) at 3 months (P < .05). The investigation of groups classified by prostate size demonstrated that the IPSS in group 3 continued at a significantly lower level than that in groups 1 and 2. The prostate volume decreased gradually and resulted in 52.8% volume reduction for ≤ 12 months. No significant complications were seen; however, irritative symptoms occurred frequently (11.3%).

Conclusion: Transurethral resection in saline vaporization was a safe and effective treatment option and was more efficacious for patients with a larger prostate. The bother scores and prostate volume gradually decreased for ≤ 12 months.

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http://dx.doi.org/10.1016/j.urology.2011.09.044DOI Listing

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