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Transurethral Electrovaporization of the Prostate: Preliminary Clinical Results with Pressure‐Flow Analysis
Author(s) -
Okada Takuya,
Terai Akito,
Terachi Toshiro,
Okada Yusaku,
Yoshida Osamu
Publication year - 1998
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/j.1442-2042.1998.tb00235.x
Subject(s) - medicine , prostate , urology , hyperplasia , bladder outlet obstruction , transurethral resection of the prostate , international prostate symptom score , urine flow rate , hematocrit , lower urinary tract symptoms , urinary system , cancer
Background We evaluated the safety and efficacy of transurethral electrovaporization of the prostate (TVP) as a new alternative treatment for patients with benign prostatic hyperplasia. Methods A total of 22 patients with symptomatic benign prostatic hyperplasia, including 4 with urinary retention, underwent TVP. If enough of a cavity was not created after 60 minutes of vaporization, transurethral resection of the prostate (TURP) was performed successively. International Prostate Symptom Score (l‐PSS) with quality‐of‐life index, maximum flow rate, and postvoid residual volume were measured at baseline and at 2 weeks, 1, 3, and 6 months. A pressure‐flow study was performed at baseline and at 3 or 6 months after surgery. Results TURP was required in 10 of 22 patients. At 6 months, mean l‐PSS decreased from 20.0 to 5.2, quality‐of‐life index decreased from 4.6 to 1.1, mean maximum flow rate increased from 6.9 to 16.7 mL/s, and postvoid residual volume decreased from 152 to 32 mL. Detrusor pressure at maximum flow decreased from 108 to 39 cm H 2 0, with a significant relief of bladder outlet obstruction in 93% of the patients. Mean decrease in hematocrit was 4.4%, and in serum sodium, 4.8 mEq/L. None of the patients required transfusions or had TUR syndrome. A urethral stricture and a severe stress incontinence developed in 1 patient. Conclusion TVP seems to be a safe and effective alternative to a standard TURP associated with fewer intraoperative complications. Although preliminary clinical results have been promising, further study is necessary to establish long‐term efficacy and safety of this procedure.