Rapid communication: photoselective vaporization of the prostate versus transurethral resection of the prostate for the large prostate: a prospective nonrandomized bicenter trial with 2-year follow-up.

PURPOSE: To present our 2-year data comparing photoselective vaporization of the prostate (PVP) and transurethral resection of the prostate (TURP) for patients suffering from lower urinary tract symptoms (LUTS) secondary to large-volume benign prostatic hyperplasia.

MATERIALS AND METHODS: In this prospective, nonrandomized study, 81 patients with a prostate volume of between 70 and 150 mL underwent either PVP (40) or TURP (41). All patients were preoperatively assessed by International Prostate Symptom Score (IPSS), transrectal ultrasonography (TRUS), uroflowmetry, and postvoid residual urine (PVR) measurement. We compared parameters, complications, and functional follow-up between the groups.

RESULTS: The baseline characteristics of the two groups were similar. Mean operative time was 126.2 +/- 17.4 minutes for PVP and 77.9 +/- 8.3 minutes for TURP (P < 0.001). Bleeding requiring blood transfusion in one patient and transurethral resection (TUR) syndrome in one patient were observed in the TURP group. Catheter indwelling times and hospitalization times of patients in the PVP group were all shorter than those of patients in the TURP group (P < 0.001). In both the groups, an immediate and highly significant improvement of maximum urinary flow rate (Q(max)), PVR, and IPSS was evident. Capsule perforation was observed in one patient undergoing TURP. Reoperation was required in three patients in the group of PVP and one patient in the TURP group. We observed urethral stricture in two patients after TURP.

CONCLUSION: The postoperative micturition improvement was significant and lasting, and was equivalent in both groups. The rate of late complications is equally low with both procedures. Catheterization time and hospital stay were significantly shorter with PVP.