Comparison of photoselective vaporization of the prostate and transurethral resection of the 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 benign prostatic hyperplasia (BPH).

PATIENTS AND METHODS: In this prospective non-randomized study, 210 patients with a prostate volume <70 mL underwent PVP (112) or TURP (98). Functional follow-up included measurement of maximum urinary flow rate (Q(max)), post-void residual urine volume (PVR), International Prostate Symptom Score (IPSS), and quality-of-life score (QoL) within a 24-month period. While anticoagulant therapy was discontinued before the operation in the TURP group, it was not discontinued in the PVP group.

RESULTS: Baseline characteristics of both groups were similar. Mean operative time was 55.5 +/- 21.8 minutes for PVP and 46.0 +/- 8.7 minutes for TURP (P < 0.001). No statistically significant difference was observed between postoperative serum sodium and hemoglobin values in both groups (P > 0.05). Catheter indwelling time and hospitalization time of the PVP group were shorter than those of the TURP group (P < 0.001). In both groups, an immediate and highly significant improvement of Q(max), PVR, IPSS, and QoL was evident. Within 24 months urethral stricture in 3 patients after TURP and bladder neck contracture in 2 patients after PVP were observed.

CONCLUSIONS: The postoperative micturition improvement was significant and lasting, and was equivalent in both groups. The rate of complications was equally low with both procedures. PVP had the advantage of shorter hospitalization and catheter indwelling times and no need for discontinuation of anticoagulant therapy compared to TURP.