Two&amp;ndash;Year Results of Transurethral Resection of the Prostate versus Four &amp;lsquo;Less Invasive&amp;rsquo; Treatment Options

Schatzl, Georg; Madersbacher, Stephan; Djavan, Bob; Lang, Thomas; Marberger, Michael

doi:10.1159/000020220

Cited by 106 publications

(52 citation statements)

References 30 publications

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“…Despite being the 'reference standard' [1] for treating men with LUTS secondary to BPH, TURP is still associated with significant morbidity [1][2][3]. Furthermore, with improvements in TURP techniques, e.g.…”

Section: Introductionmentioning

confidence: 99%

Vaporization of prostates of ≥80 mL using a potassium‐titanyl‐phosphate laser: midterm‐results and comparison with prostates of <80 mL

et al. 2008

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OBJECTIVETo compare the safety and outcome of potassium‐titanyl‐phosphate (KTP) GreenlightTM (Laserscope, AMS, Minnetonka, MN, USA) vaporization for treating benign prostatic hyperplasia (BPH) in prostates of ≥80 vs <80 mL.PATIENTS AND METHODSIn all, 204 consecutive patients were enrolled into this prospective study; 31 were excluded from analysis for various reasons, thus 173 (median age 66.8 years; 39 with prostates of ≥80 mL) were evaluated for maximum urinary flow rate (Qmax), postvoid residual urine (PVR), the International Prostate Symptom Score (IPSS), and quality‐of‐life (QoL) score. The median follow‐up was 11.7 months. Of the 173 men, 26.6% were anaesthesiological high‐risk patients and 32.4% took anticoagulants.RESULTSThe Qmax improved in prostates of ≥80 mL from 6.9 mL/s before to 15.3 mL/s immediately after catheter removal, and 23.4 mL/s after 3 months (P < 0.001). The improvement was similar to that in smaller prostates. There were equally effective changes in PVR (P < 0.001). The IPSS decreased from 19.0 before to 7.0, 4.0 and 5.5 at 3, 6 and 12 months after surgery (P < 0.001). Changes did not differ from those in smaller glands. The results were similar for QoL (P < 0.001). During surgery there was no major bleeding and no transurethral resection syndrome. There was acute urinary retention after catheter removal in 10.4% of men; 4.6% developed urinary tract infections, whereas the rate was higher in men with larger prostates (10.3%). The re‐operation rate was higher in men with larger prostates, at 23.1% vs 10.4% (P = 0.09).CONCLUSIONKTP laser vaporization is a safe and effective procedure for surgically treating BPH. The functional outcome in larger prostates is similar to that in smaller glands, but there was a serious trend to a higher re‐operation rate in men with larger prostates.

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Section: Introductionmentioning

confidence: 99%

Vaporization of prostates of ≥80 mL using a potassium‐titanyl‐phosphate laser: midterm‐results and comparison with prostates of <80 mL

et al. 2008

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“…Irrespective of a large number of alternative surgical procedures available today, TURP is still regarded as an effective surgical technique with excellent functional short-term results [8][9][10] . Based on technical improvement and a growing clinical expertise, perioperative mortality associated with TUVRP has decreased dramatically, approaching zero within the last decade 11 .…”

Section: Discussionmentioning

confidence: 99%

A retrospective analysis of transurethral vapor resection of the prostate versus transvesical prostatectomy for prostate greater than 50 ml

Argirovic¹,

Argirović²

2012

Mat Med

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We compared the safety and efficacy of transurethral vapor resection (TUVRP) and transvesical prostatectomy (TVP) for prostate > 50 ml in retrospective study. Ninety patients with urodynamic obstruction and prostate volume (PV) in range between 50 and 100 ml were analyzed according to the mode of operative treatment (TUVRP vs. TVP). Patients were assessed preoperatively and followed-up at 3 and 12 months postoperatively. All patients underwent general and urological standard evaluation before surgery, including urine analysis, urine culture, blood samples tests, with determination of PSA, DRE, abdominal and minor pelvis ultrasound (US), transrectal ultrasound (TRUS), maximal flow rate (Qmax), postvoid residual urine(PVR), and self assessment by International Prostate Symptom Score (IPSS) and Quality of Life Score (QoLS). Urethrocystoscopy was obligatory done before TUVRP. TRUS-guided biopsies of the prostate were performed in patients with PSA > 4 ng/ml, abnormal DRE, and/or suspicious echogenicity on TRUS. IPSS, QoLS, Qmax and PVR were obtained at each follow-up. Of 90 patients eligible to participate, 69 patients completed 12 months of follow-up (TUVRP, n=35; TVP, n=36). TUVRP procedure was not faster than TVP procedure (P=0.41); 43.6% and 84.8% of prostatic tissues were resected after TUVRP and TVP, respectively (P<0.001). In TVP group, IPSS, QoLS, Qmax and PVR volume were significantly better than those in TUVRP group at 3 and 12 months of followup. At 12 months postoperatively, IPSS improved 62.7% and 87.9% (P<0.001), QolS decrease by 41.9% and 71.9% (P<0.001), mean Qmax increased by 6.3 ml/s (102.0%) and 11.4 ml/s (230.2%) (P=0.001) and mean PVR volume decreased by 65.4 ml (70.5%) and 71.2 ml (88.6%) (P=0.001) in TUVRP and TVP ApstraktProvedena je retrospektivna analiza efikasnosti transuretralne vapor resekcije (TUVRP) i transvezikalne prostatektomije (TVP) kod prostata > 50 ml. Devedeset pacijenata sa znacima urodinamske opstrukcije i volumenom prostate (VP) između 50 i 100 mL, su analizirani u zavisnosti od metode operativnog tretmana (TUVRP prema TVP). Pacijenti su imali određivanje kliničkih parametara preoperativno i prilikom praćenja na 3 i 6 meseci postoperativno. Svi pacijenti su imalu opštu i standarnu urološku evaluaciju pre hirurškog lečenja uključujući analizu urina, urinokulturu, analizu krvi sa određivanjem PSA, rektalni pregled prostate (RT), ultrazvuk abdomena i male karlice (UZ), transrektalni ultrazvuk prostate (TRUZ), određivanje maksimalnog protoka urina (MPU), rezidualnog urina posle mokrenja (RU), Internacionalnog Prostata Simptom Skora (IPSS), i ocenu kvaliteta života (KŽ). Uretrocistoskopija je obavezno rađena pre TUVRP. TRUZ-vođena biopsija prostate je rađena kod pacijenata sa vrednostima PSA > 4 ng-ml, abnormalnim RT i/ili sumnjivim nalazom na TRUZ. IPSS, KŽ. MPU i RU su određivani pri svakoj kontroli. Od 90 pacijenata podesnih sa evaluaciju, 69 pacijenata je kompletiralo lečenje za period od 12 meseci (TUVRP, n = 35; PTV, n = 36). TUVRP procedura nije bila brža (P=0.41)...

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“…Several aspects have to be taken into account when discussing invasive treatment modalities, such as e.g. subjective and objective outcome parameters, intra/postoperative complications and especially the need for re-treatment in the long-term [102]. With regard to subjective outcome parameters, all invasive treatment modalities resulted in a substantial decrease in urinary symptoms although a wide range of response was found ranging from –52% for the contact laser to –87.5% for TUIP.…”

Section: Discussionmentioning

confidence: 99%

Invasive and Minimally Invasive Treatment Modalities for Lower Urinary Tract Symptoms: What Are the Relevant Differences in Randomised Controlled Trials?

Tubaro¹,

Vicentini²,

Renzetti³

et al. 2000

Eur Urol

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Two–Year Results of Transurethral Resection of the Prostate versus Four ‘Less Invasive’ Treatment Options

Cited by 106 publications

References 30 publications

Vaporization of prostates of ≥80 mL using a potassium‐titanyl‐phosphate laser: midterm‐results and comparison with prostates of <80 mL

Vaporization of prostates of ≥80 mL using a potassium‐titanyl‐phosphate laser: midterm‐results and comparison with prostates of <80 mL

A retrospective analysis of transurethral vapor resection of the prostate versus transvesical prostatectomy for prostate greater than 50 ml

Invasive and Minimally Invasive Treatment Modalities for Lower Urinary Tract Symptoms: What Are the Relevant Differences in Randomised Controlled Trials?

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