Comparison of Transurethral Vaporization Using PlasmaKinetic™ Energy and Transurethral Resection of Prostate: 1-Year Follow-Up

Abstract

Purpose: A prospective study was conducted to evaluate the efficacy and safety of PlasmaKinetic™ vaporization of prostate (PKVP) relative to standard transurethral resection of prostate (TURP) in the surgical management of benign prostatic hyperplasia (BPH). Patients and Methods: Between March of 2001 and February of 2003, 75 patients aged 49 to 80 years (median 66 years) with a complaint of lower urinary-tract symptoms and a mean prostate volume of 50 ± 6 cc were enrolled in this study. We evaluated the operating time, blood transfusion, postoperative irrigation period, and catheter-removal time. Patients were assessed at baseline and during the follow-up using the International Prostate Symptom Score (IPSS) and maximum urinary flow rate (Q_max). Results: The mean operation time for PKVP (40.3 ± 15 minutes) was significantly shorter than that of TURP (55 ± 11.1 minutes) (P < 0.001). The postoperative irrigation period was significantly shorter in the PKVP group (mean 6 ± 3 hours) than in the TURP group (mean 20 ± 8 hours) (P < 0.001). The mean catheter-removal time was significantly later after TURP (68 ± 21 hours) than after PKVP (35 ± 9 hours) (P < 0.001). The groups had comparable mean IPSS and Q_max values at baseline, and both had significant improvement in these parameters after operation. For IPSS, especially at the third month after the operation, PKVP patients showed significantly greater improvement (P < 0.001). There was no difference in Q_max values between the groups (P > 0.05). Whereas blood transfusion was necessary for two patients in the TURP group, there were no transfusions in the PKVP group. Conclusions: Because of the short operating time, smaller blood loss, shorter period of irrigation and catheterization, use of isotonic fluid, and absence of electrical current, PKVP is safe and advantageous. Although these early results have shown that this technique may be a good alternative among the minimally invasive methods for the surgical management of BPH, further studies with longer-term results are essential.