A Comparative Study of Transurethral Resection of the Prostate Using a Modified Electro-Vaporizing Loop and Transurethral Laser Vaporization of the Prostate

Abstract

We determined the relative efficacy of a modification of transurethral resection of the prostate using a vaporizing loop (VaporTrode^* ) with transurethral laser vaporization of the prostate using the Ultraline^† fiber. A comparative trial of 58 patients with symptomatic prostatism was performed. Parameters evaluated included operative time, postoperative catheterization time, American Urological Association (AUA) symptom score, peak urine flow and post-void residual urine. Of the 29 patients who underwent electro-vaporization AUA symptom score decreased from 15.3 to 5.3 and 4.9, and peak urine flow increased from 8.2 to 14.9 ml. per second and 15.6 ml. per second at 1 and 3 months, respectively (p = 0.01). Of the 29 patients undergoing laser vaporization of the prostate AUA symptom score decreased from 14.7 to 10.1 and 7.6, and peak urine flow increased from 9.7 to 13.7 ml. per second and 14.9 ml. per second at 1 and 3 months, respectively (p = 0.025). However, there were significant differences in mean catheterization time (electro-vaporization group 14.7 hours and laser group 79.6 hours, p less than 0.001), and cases of postoperative irritative symptoms (3 electro-vaporization and 19 laser) and retention requiring repeat catheterization (6 laser). Our early clinical experience highlights several potential advantages of electro-vaporization, particularly the low incidence of postoperative morbidity. Currently a multicenter clinical trial is underway to determine the long-term efficacy and safety of electro-vaporization as a potential therapeutic modality in the treatment of men with symptomatic benign prostatic hyperplasia.