Photoselective vaporization of the prostate (PVP) for BPH provides outcomes similar to those of transurethral resection of the prostate (TURP).
In a study led by Volkan Tugcu, MD, of the Bakirkoy Training and Research Hospital in Istanbul, Turkey, 112 patients underwent PVP with an 80W potassium-titanyl-phosphate (KTP) laser and 98 underwent TURP. The groups had similar baseline characteristics. The mean preoperative prostate size was 47.7 g in the TURP group and 49.1 in the PVP group.
The mean operative time for the PVP group was 59 minutes compared with 45 minutes for the TURP group, but the PVP-treated patients had shorter indwelling catheter times and hospital stays, the researchers reported at the 22nd European Association of Urology Congress in Berlin.
At 24 months, the mean International Prostate Symptom Score (IPSS) decreased from 17.9 to 3.1 in the PVP group and from 17.7 to 2.9 in the TURP group. The maximum urinary flow rate increased from 6.9 to 16.8 mL/sec in the PVP group and from 7.3 to 12.8 mL/sec in the TURP group.
Post-void residual volume (PVR) decreased from 107.9 to 7.5 mL in the PVP group and 100.3 to 7.6 mL in the TURP group. Capsule perforation occurred in four TURP patients. Within 24 months, urethral stricture occurred in three patients following TURP and bladder neck contracture occurred in two patients after PVP.
“Although efficacies of TURP and PVP were similar, PVP had the advantage of short hospitalization time and catheter indwelling time compared to TURP,” the authors concluded.
In another study, a group at Istanbul Memorial Hospital showed that PVP with the KTP laser and TURP provided comparable six-month outcomes in BPH patients with prostates larger than 80 g. The investigators randomly assigned 32 patients to undergo TURP and 28 to undergo PVP. The mean preoperative prostate size was 91.8 g in the TURP group and 89.1 in the PVP group.
Operating room time was significantly shorter for the TURP-treated patients (68.7 vs. 99.6 minutes), but catheter indwelling time and hospital stay were shorter in the PVP arm (1.6 vs. 4.1 days and 1.1 vs. 2.8 days, respectively).
IPSS, PVR, and maximum flow rates had improved similarly in both groups at the six-month follow-up. At 12 months, however, the TURP group had significant greater improvement in IPSS and maximum flow rates.