A comparison on the efficiency and safety between two morcellators for laser enucleation of the prostate: Piranha versus Cyber Blade. A randomized controlled trial.

BACKGROUND

We performed a comparison between the Wolf® Piranha™ and the Quanta System® Cyber Blade™ morcellators for the Thulium laser enucleation of the prostate (ThuLEP).

METHODS

Overall, 205 patients underwent ThuLEP in three urologic departments (Como, Bordeaux, Madrid). Patients were randomized to Piranha morcellator with disposable blades (100 cases, Group A) or Cyber Blade morcellator (105 cases, Group B). Morcellation efficiency was related to prostate volume (PV) using the cut-off of 100 mL. Complication rate and device malfunctions were reported. The Chi-square Test was used for the comparison of the study groups. All statistical tests were two-sided with a level of significance at P<0.05.

RESULTS

Mean PV was 82.5 vs. 91.9 mL (P=0.21) in Group A vs. B. Mean morcellation time was 9.7 vs. 10.1 min in Group A vs. B when PV was ≤100 mL (P=0.34), it was significantly lower in Group B when PV was >100 mL (12.7 vs. 10.1 min, P=0.04). Similarly, morcellation efficiency was comparable when PV was ≤100 mL (8.5 vs. 9.1 g/min, P=0.08), while it was significantly higher with the Cyber Blade when PV was >100 mL (10.0 vs. 12.3 g/min, P=0.04). Bladder injury occurred in three and two cases in Group A and B. Complication rate was comparable.

CONCLUSIONS

Piranha and Cyber Blade morcellators showed a comparable efficacy when PV was ≤100 mL, while efficacy was significantly higher with the Cyber Blade when PV was >100 mL. Both instruments are safe and reliable according to the risk of bladder injury and the occurrence of mechanical problems.