The long‐term results of transurethral vaporization of the prostate using plasmakinetic energy
- 11 January 2007
- journal article
- research article
- Published by Wiley in BJU International
- Vol. 99 (4), 845-848
- https://doi.org/10.1111/j.1464-410x.2006.06683.x
Abstract
To assess the long-term efficacy and the safety of plasmakinetic vaporization of prostate (PKVP, Gyrus Medical Ltd., Bucks, UK) against standard transurethral resection of the prostate (TURP) for symptomatic prostatic obstruction.Of 75 patients admitted to our clinic with symptomatic prostatic obstruction between 2001 and 2003, 40 who were randomized to undergo either TURP or PKVP, and who had returned for the follow-up, were included in this study. All treated patients completed the 36-months of follow-up; 25 had had PKVP and 15 a standard TURP. After surgery the treatment outcome was evaluated using the International Prostate Symptom Score (IPSS), maximum urinary flow rate (Q(max)) and long-term complications of surgery.The two groups had similar baseline characteristics. The improvement in both groups was statistically significant for the IPSS and Q(max) at 24 and 36 months vs the baseline values (P < 0.05). The mean (sd) IPSS decreased from 21 (3.4) to 7.1 (1.5) and 7.6 (1.4) after PKVP and from 22 (3.8) to 5.2 (1.1) and 5.7 (1.2) after TURP, at 24 and 36 months, respectively. The mean Q(max) for the both groups increased significantly from baseline values at 2 and 3 years, respectively, at 20.8 (2.4) and 21.8 (3.1) mL/s after TURP, which was statistically significantly better than after PKVP, at 12.5 (2.1) and 14.4 (2.6) mL/s, respectively (P < 0.05). Although three patients (12%) in the PKVP group had TURP at 14, 20 and 36 months, respectively, for residual adenoma tissue, one patient had an additional operation after TURP. Bulbar urethral strictures occurred in one patient in each group, requiring internal optical urethrotomy. Erectile dysfunction was reported by three patients after PKVP (12%) and by two of 15 after TURP who were potent before surgery (P > 0.05). The retrograde ejaculation rates in patients with erectile function were similar in both groups (56% and nine of 15, respectively; P > 0.05). In the PKVP and TURP groups, 12 (48%) and nine of 15 patients were satisfied overall.Although early results showed that PKVP was a good alternative technique among the minimally invasive methods for surgically managing prostatic obstruction, the clinical outcome of PKVP in the long term was not comparable to the results after TURP.Keywords
This publication has 22 references indexed in Scilit:
- Impact on Sexual Function of Holmium Laser Enucleation Versus Transurethral Resection of the Prostate: Results of a Prospective, 2-Center, Randomized TrialJournal of Urology, 2006
- Reoperation, Myocardial Infarction and Mortality after Transurethral and Open Prostatectomy: A Nation-Wide, Long-Term Analysis of 23,123 CasesEuropean Urology, 2005
- A meta‐analysis of trials of transurethral needle ablation for treating symptomatic benign prostatic hyperplasiaBJU International, 2004
- Histological Changes of Minimally Invasive Procedures for the Treatment of Benign Prostatic Hyperplasia and Prostate Cancer: Clinical ImplicationsJournal of Urology, 2003
- Electrovaporization of the Prostate with the Gyrus DeviceJournal of Endourology, 2001
- Erectile Dysfunction Following Transurethral Resection of the ProstateJournal of Urology, 1996
- Erectile Dysfunction Following Transurethral Resection of the ProstateJournal of Urology, 1996
- Incidence of Erectile Impotence Secondary to Transurethral Resection of Benign Prostatic Hyperplasia, Assessed by Preoperative and Postoperative Snap Gauge TestsJournal of Urology, 1995
- Incidence of Erectile Impotence Secondary to Transurethral Resection of Benign Prostatic Hyperplasia, Assessed by Preoperative and Postoperative Snap Gauge TestsJournal of Urology, 1995
- A Comparison of Transurethral Surgery with Watchful Waiting for Moderate Symptoms of Benign Prostatic HyperplasiaNew England Journal of Medicine, 1995