INTRODUCTION: The aim of the present study was to compare the safety and efficacy of transurethral electrovaporization of the prostate (TUVP) with conventional transurethral resection of the prostate (TURP) in the treatment of patients with moderate to severe bladder outlet obstruction due to benign prostatic hyperplasia (BPH).

METHODS: Between December 2001 and November 2003, 131 patients presented to the author's institution with moderate to severe bladder outflow symptoms due to BPH. The patients were randomly assigned to undergo TURP (n = 67) or TUVP (n = 64). Patients receiving TURP had a significantly larger mean prostate size (P = .01) but were similar in all other evaluated characteristics. Using the hospital database, the author reports the available follow-up results after 1, 2, 3, and 5 years. The International Prostate Symptom Score (IPSS), uroflowmetry (Q-max), and postvoid residual volume (PVR) were used for evaluation. Operative time, catheterization time, hospital stay, and blood tests were also compared.

RESULTS: Of the 131 total patients, 51 patients receiving TURP and 50 patients receiving TUVP completed 5 years of follow-up; 21 patients died and the remaining 9 could not be contacted. No deaths were associated with either resection or vaporization of the prostate. Patients receiving TURP had a significantly longer mean postoperative catheterization time (P < .001) and mean hospitalization time (P < .001). Patients had significantly lower mean serum hemoglobin and hematocrit 1 hour following TURP (P < .001). There were no significant group differences for any other measures.

CONCLUSIONS: To the author's knowledge, the present study is the largest reported comparison of TURP and TUVP over a 5-year follow-up period. The low intraoperative and perioperative morbidity, rapid convalescence time, short hospital stay, and simplicity of the procedure make TUVP a potentially suitable, safe alternative to TURP in the therapeutic armamentarium for BPH. Because of its unique electrosurgical properties, higher risk patients can be treated successfully with this technique. The main disadvantage of TUVP appears to be the unavailability of prostate tissue needed for pathologic examination. Additionally, although TURP and TUVP were found to be comparable for prostate sizes < 60 g for patients in the present study, TURP may be advantageous for patients with larger prostates.

KEYWORDS: Transurethral electrovaporization of the prostate (TUVP); Transurethral resection of the prostate (TURP).

CORRESPONDENCE: Ehab Rifat Tawfiek MD, Department of Urology, El Minia University Hospital, Elminia 16666, Egypt (ehabr1966@yahoo.com).

CITATION: UroToday Int J. 2009 Dec;2(6). doi:10.3834/uij.1944-5784.2009.12.12