ABSTRACT
In this study, we compared the efficacy and advantage of TUR-P, which is still the golden standard, with transurethral electrovaporisation of the prostate (TVP).
One hundred and eighty seven patients who were admitted to our polyclinic with lower urinary tract infections due to BPH between Jan 2002-July were included in the study (average age 67.8±8.3). The patients were randomized into 2 groups. TUR-P was performed on the 1st (n=93, average age 63.7±4.2) and TVP operations were performed on the 2nd group (n=94, average age 69.9±6.2). The medical history of all patients were obtained before the operation. Physical examination was performed (including TR). Routine biochemical tests including PSA, hemogram and urinanalysis were performed. Maximum urine flow rates (Qmax), amount of residual urine in the bladder after voiding (PVRİ), prostate volume (PV) with TRUS guidance was measured. The International prostatic symptom score survey (IPSS) was filled out. Spinal anesthesia was performed in 17 (18%) and 15 (16%) of patients on whom TUR-P and TVP was performed respectively. In the long-term follow-up of patients after surgery, IPSS, Qmax and PVRİ values were performed. Statistical analysis was performed using Statistical Package for Social Sciences 15.0 (SPSS Inc., Chicago, IL, USA).
There was no statistical difference according to age, IPSS before surgery, Qmax, PVRI, PV values between 93 patients on whom TUR-P was performed and the 94 patients on whom TVP was performed. IPSS, Qmax and PVRI values were similar after surgery in the 1st and 3rd months and in the 1st and 3rd year. The therapeutic efficacy for both of the methods were similar. The decrease in hematocrits and post-operative hyponatremia was lower in the TVP group.
In the post-operative follow-up, although there was no statistical difference in the efficacy, duration of operation and blood loss, the decline in hematocrits was observed as slightly greater in the TVP group. A similar situation applies for the serum sodium concentrations. In our study, we did not observe differences regarding IPSS, Qmax and PVRİvalues during our follow-up period. TUR-P is still the gold standard for the surgical treatment of BPH. Nevertheless, an alternative treatment method for TUR-P is still being worked on. One of these alternative methods is TVP. Although there are no differences in terms of efficacy with TVP, as there is less blood loss and TUR syndrome risk, the TVP stands out as a selectable method. (JAREM 2011; 1: 12-4)
Keywords: Transurethral electrovaporisation, BPH, TUR-P
