Bipolar transurethral resection of the prostate (TURP) in combination with high-intensity diode laser (DL + b-TURP) is feasible for treatment of benign prostatic hyperplasia (BPH) in large prostates, according to study findings published in Lasers in Surgery and Medicine (2012;44:699-704).
Chien-Hsu Chen, MD, of the Chang Gung University College of Medicine in Kaohsiung, Taiwan, and colleagues retrospectively analyzed patients with lower urinary tract symptoms (LUTS) secondary to BPH with prostates larger than 80 mL, undergoing monopolar TURP (36 patients) or DL + b-TURP (37 patients), to compare efficacy and safety. Functional parameters were assessed preoperatively and at follow-up.
The researchers found that preoperative prostate volume was 110.8 mL in the DL + b-TURP group and 103.7 mL in the TURP group. Catheterization time and hospital stay were significantly in favor of the DL + b-TURP group, while the TURP group had significantly shorter operative time. The TURP group also had a significantly greater decrease in hemoglobin. Both groups were comparable with respect to late complications. Significant improvements in functional outcomes were seen for both groups during the 24-month follow-up.
“Comparing the difference between DL + b-TURP and monopolar TURP for the treatment of large prostates, this retrospective study indicated that the former could offer excellent intraoperative hemostasis, shorter catheterization time, and shorter hospital stay,” the investigators wrote. “In consideration of safety and efficacy, this combination may be a feasible strategy in the management of large prostates.”