Objective: To compare the safety, efficacy and durability of transurethral electrovaporization of the prostate (TUVP) with standard transurethral resection of the prostate (TURP).
Patients and methods: In all, 104 patients admitted from the waiting list for surgery for BPH were randomized to either TUVP (52 patients, mean age 67.5 years) or TURP (52 patients, mean age 70.2 years); 51, 47 and 40 patients in each arm completed 1, 2 and 3 years of follow-up, respectively. Patients were assessed at baseline and during the follow-up using the International Prostate Symptom Score (IPSS), the associated quality-of-life score (QoL), postvoid residual volume (PVR) and maximum urinary flow rate (Qmax).
Results: Both groups had comparable mean IPSS, QoL, Qmax and PVR at baseline. The mean (SD) values for TUVP and TURP, respectively, at 3 years showed a significant and maintained improvement in IPSS, at 4.1 (3.3) and 7.1 (6.2) (P = 0.01), in QoL, at 1.0 (0.9) and 1.6 (1.4) (P = 0.04), and in Qmax, at 22.2 (8.5) and 18 (7.1) mL/s (P = 0.02), with decreases in PVR of 30 (38) and 21.9 (26.2) mL (P = 0.27). The re-operation rate in each group was 4% during the first year, 4% during the second year and 5% during the third year. After surgery and at 1, 2 and 3 years of follow-up, impotence was reported in 17% of the TUVP group and 11% of the TURP group (P = 0.49), and retrograde ejaculation in 72% of the TUVP group and 89% of the TURP group (P = 0.47).
Conclusion: The 3-year follow-up results confirm that TUVP is as effective as standard TURP in the treatment of moderate-sized BPH. The long-term side-effects and complications were comparable and the initial improvement was maintained over 3 years in most patients in both groups.