Clinical comparison of two minimal invasive techniques in the treatment of benign prostatic enlargement over 90 ml: BIVAP (Richard Wolf®) saline vaporization of the prostate vs. bipolar plasmakinetic TURP.

OBJECTIVES

The aim of this study is to evaluate the efficacy, safety and postoperative outcomes of the recently developing endoscopic techniques of Bi-Vap (Richard Wolf®) saline vaporization of the prostate and bipolar plasmakinetic TURP in BPE over 90 ml.

METHODS

In total, we included 147 patients treated with BiVap (Richard Wolf®) saline vaporization of the prostate (n=75) and bipolar plasmakinetic TURP(n=72). The inclusion criteria were Qmax ≤10 mL/s,IPSS ≥16, and prostate volume over 90 ml. Operation, hospitalization and catheter removal time were noted. Postoperative complications including urinary tract infection, transient hematuria, severe dysuria, and fever >38°C, urinary incontinence and urethral stricture were also noted. All patients were evaluated at the postoperative month 3. Preoperative and postoperative values of IPSS score, QoL score, IIEF-5, PVR, Qmax and Qave were compared. Statistical analyses were performed using SPSS 18.0 program and statistical significance was set at p<0.05.

RESULTS

The groups were similar with respect to preoperative age, height, weight, creatinine, PSA, prostate volume, IPSS score, Qmax, Qave, QoL score, PVR and IIEF-5 values. The mean operation time was significantly higher (<0.001) removal were significantly lower (0.001) compared to group 1. The groups were similar regarding at postoperative month 3 IPSS score, Qmax, Qave,QoL score, PVR and IIEF-5 values. The only exception was the rate of severe dysuria, which was significant lyhigher in group 2.

CONCLUSION

Both BiVap (Richard Wolf®) saline vaporization of the prostate and bipolar plasmakinetic TURP are safe and highly effective minimal invasive techniques, which can be used in the surgical treatment of BPE over 90 ml. Although the longer operation time and higher rate of postoperative irritative symptoms, Bi-Vap (Richard Wolf®) saline vaporization of the prostate seems to be a potential alternative to other techniques with shorter length of stay and time to catheter removal.