EAU 2019: Thulium Laser Transurethral Vaporesection of the Prostate Versus Transurethral Resection of the Prostate: Results of the UNBLOCS Randomized Controlled Trial

Barcelona, Spain (UroToday.com)  Transurethral resection of the prostate (TURP), using electro-cautery, is the commonest surgical procedure for benign prostatic obstruction (BPO). Thulium-laser transurethral vaporesection of the prostate (ThuVARP) is a relatively new technique which vaporises and resects the prostate similarly to TURP

Dr. Hashim from Bristol Urological Institute, Bristol, United Kingdom, presented data from randomized controlled, parallel-group, blinded phase III trial was conducted in seven NHS UK centres which involved 410 men presenting with voiding LUTS or urinary retention secondary to BPO.

IPSS scores reduced equally for both procedures with a small benefit for TURP in Qmax. Surgical complications, transfusion rates and hospital stay were similar for both procedures. Patient experiences (37 interviews) and urinary and sexual outcome measures were similar across treatments.  ThuVARP took 20 minutes on average longer than TURP. Costs were similar, at £4185 for TURP and £67 higher for ThuVARP (95% CI: -£353 to £486).

Dr. Hashim concluded that ThuVARP mostly demonstrated similar outcomes to TURP. TURP was superior for Qmax,although both were clinically successful. ThuVARP also detected less prostate cancer, incidentally. The anticipated benefits of length of stay and bleeding for ThuVARP were equal to TURP. Overall, ThuVARP and TURP are effective BPO treatments, with minor clinical benefits favouring TURP.

Presented by: Professor Hashim Hashim, North Bristol NHS Trust, Bristol Urological Institute, Bristol, United Kingdom

Written by: Dmitry Korolev, Institute for Urology and Reproductive Health, Moscow, Russia at the 34th European Association of Urology (EAU 2019) #EAU19, conference in Barcelona, Spain from March 15-19, 2019.