Vapor Resection: A Good Alternative to Standard Loop Resection in the Management of Prostates &gt;40 cc

Gupta, Narmada P.; Doddamani, D; Aron, Monish; Hemal, A.K.

doi:10.1089/08927790260472944

Cited by 20 publications

(12 citation statements)

References 17 publications

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“…In TUVRP, there is resection of tissue as in standard TURP; therefore, the outcome is as good as TURP. In 2002, Gupta et al [15] conducted a study that compared standard TURP with TUVRP in prostates more than 40 grams. The procedure is associated with better hemostasis and shorter operative time [8].…”

Section: Transurethral Vapor Resection Of the Prostatementioning

confidence: 99%

Comparison of TURP, TUVRP, and HoLEP

Gupta

Anand²

2009

Curr Urol Rep

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Since the first transurethral resection of the prostate (TURP) was performed by Guyon at the Necker Hospital in Paris in 1901, this treatment modality has replaced open prostatectomy as the procedure of choice for more than 95% of patients. TURP has been used in surgical treatment of benign prostatic hyperplasia (BPH) and remains the gold standard treatment. Transurethral vapor resection of the prostate (TUVRP) and holmium laser enucleation of the prostate (HoLEP) are new treatment modalities for the treatment of BPH. Each procedure has its own advantages and disadvantages. Availability of instruments, surgical expertise, and specific indications for a particular procedure are of utmost importance for successful outcome, with minimal morbidity. TURP can be either monopolar or bipolar, using thin or thick loop. Bipolar TURP is associated with less bleeding and less chances of dilutional hyponatremia. TUVRP, using a thick wedge loop, causes vaporization and resection of the prostate, and is associated with less bleeding and short operative time. HoLEP is another effective alternative for the surgical treatment of BPH. The holmium laser possesses the ideal combination of cutting and coagulation; however, it has a learning curve.

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Section: Transurethral Vapor Resection Of the Prostatementioning

confidence: 99%

Comparison of TURP, TUVRP, and HoLEP

Gupta

Anand²

2009

Curr Urol Rep

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“…The advantage of TUVRP includes instantaneous bulky tissue removal, with greater visibility, better hemostasis, and less bleeding [13][14][15][16] . We demonstrated that average time for postoperative irrigation was significantly reduced, including the volume of irrigant fluid, diminished admission time and early catheter removal.…”

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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“…A number of clinical trials have been performed using transurethral vaporization of the prostate [7][8][9]. To the best of our knowledge, it would appear that such procedures have, in general, little advantages as regards the clinical outcome when compared with the TURP procedure.…”

Section: Discussionmentioning

confidence: 99%

Transurethral Electrovapor Resection versus Standard Transurethral Resection Treatment for a Large Prostate: A 2-Year Follow-Up Study Conducted in Taiwan

Liu

Lee

et al. 2006

Urol Int

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Introduction: Those patients featuring a large prostate and undergoing transurethral resection typically face a longer duration of surgery, they have a higher degree of hemorrhage and a higher irrigant volume required for the procedure, and they tend to reflect a higher incidence of morbidity than is the case for a small prostate. We report on the relative safety and efficacy of transurethral electrovapor resection of the prostate (TUVRP) as compared with standard transurethral resection of the prostate (TURP) for Taiwanese patients having a prostate size >50 ml. Patients and Methods: Seventy-six symptomatic benign prostatic hyperplasia patients featuring a prostate size >50 ml were randomized and underwent either TUVRP using wedge loop or standard TURP. Perioperative parameters, treatment outcome, and adverse events associated with the surgical procedure are assessed herein. Results: Mean operation time, changes in hemoglobin levels, resected prostate weight, perioperative irrigant volume needed, and incidences of recatheterizations and readmissions, all differed significantly when the two surgical procedures were compared. The average expense differences for the two procedures were impressive (p < 0.0001). No postoperative intergroup sexual dysfunction differences were noted. Clinical improvements following either TUVRP or TURP were significant and sustained for at least a period of 2 years. Intergroup comparison of International Prostate Symptom Score, quality of life, peak flow rate, and postvoid residual volume revealed no significant differences at 2 years (p = 0.45, 0.48, 0.12, and 0.29, respectively). The need for postoperative medical retreatment and/or reoperation did not differ significantly between the two groups (p = 0.62 and p = 0.56, respectively, at 6 months and p = 0.47 and p = 0.48, respectively, at 2 years). Conclusions: The TUVRP procedure offers advantages as regards a number of perioperative parameters when compared with the TURP procedure, and it seems that TUVRP might provide at least an equivalent treatment outcome as is the case for TURP.

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Vapor Resection: A Good Alternative to Standard Loop Resection in the Management of Prostates >40 cc

Cited by 20 publications

References 17 publications

Comparison of TURP, TUVRP, and HoLEP

Comparison of TURP, TUVRP, and HoLEP

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

Transurethral Electrovapor Resection versus Standard Transurethral Resection Treatment for a Large Prostate: A 2-Year Follow-Up Study Conducted in Taiwan

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