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Continuous vs conventional bipolar plasma vaporisation of the prostate and standard monopolar resection: a prospective, randomised comparison of a new technological advance
Author(s) -
Geavlete Bogdan,
Stanescu Florin,
Moldoveanu Cristian,
Geavlete Petrisor
Publication year - 2014
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.12290
Subject(s) - medicine , international prostate symptom score , urology , prostate , perforation , transurethral resection of the prostate , prospective cohort study , surgery , lower urinary tract symptoms , materials science , cancer , punching , metallurgy
Objectives To evaluate in a prospective, randomised trial the surgical efficiency and safety of a new energy source enabling a continuous bipolar plasma vaporisation of the prostate ( C ‐ BPVP ) by comparing with standard vaporisation ( S ‐ BPVP ) and monopolar transurethral resection of the prostate ( TURP ) in men with benign prostatic hyperplasia ( BPH ). To comparatively assess the short‐term functional outcome of the three methods.Patients and Methods In all, 180 men with BPH with prostate volumes of 30–80 mL, maximum urinary flow rates ( Q max ) of <10 mL/s and I nternational P rostate S ymptom S core ( IPSS ) of >19 were equally randomised for C ‐ BPVP , S ‐ BPVP and monopolar TURP . All men were evaluated preoperatively and at 1, 3 and 6 months after surgery by IPSS , Q max , health‐related quality of life ( HRQL ) score and post‐void residual urine volume ( PVR ). The prostate volume and PSA level were postoperatively assessed at 6 months.Results The mean operation time was significantly reduced in C ‐ BPVP vs S ‐ BPVP and TURP , with a substantial 22.4% and 39.1% decrease in duration for C ‐ BPVP when compared with S ‐ BPVP and TURP , respectively. The mean haemoglobin level decrease (0.4 and 0.6 vs 1.4 g/dL), capsular perforation rate (1.7% and 3.3% vs 10%), postoperative haematuria rate (1.7% and 1.7% vs 13.3%), catheterisation period (24.1 and 23.9 vs 73.6 h) and hospital stay (2.1 and 2.2 vs 4.5 days) were significantly lower for C ‐ BPVP and S ‐ BPVP vs TURP . At 1, 3 and 6 months follow‐up, there were statistically ameliorated IPSS and Q max measurements in the C ‐ BPVP and S ‐ BPVP series, while similar HRQL scores, PVRs , PSA levels and postoperative prostate volumes were found in all three study arms.Conclusions The operation time for C ‐ BPVP was on average 20% and 40% quicker than S ‐ BPVP and TURP , respectively. Both C ‐ BPVP and S ‐ BPVP had better perioperative safety and improved follow‐up voiding and symptom scores than TURP .