Resection or Vaporization Similarly Effective for BPH

A new study reports that symptoms of benign prostatic hyperplasia (BPH) improve similarly well following either transurethral resection or photoselective vaporization by laser.

Researchers at Hospital Universitario Fundacion Alcorcon (Madrid, Spain) and Universidad Rey Juan Carlos (Madrid, Spain) conducted a randomized trial that compared the efficacy and safety of photoselective vaporization of the prostate (PVP) to transurethral resection of the prostate (TURP) in 100 men with symptoms of BPH. International Prostate Symptom Score (IPSS), quality of life (QoL), and changes in maximum flow rate (Qmax) were the main end points. Patients were evaluated at a follow-up time of two years; during this time, five patients were lost to follow-up. A last observation was used to establish carried forward analysis.

The results showed that both laser PVP and TURP resulted in the same IPPS reduction at two years, and in the same gain in Qmax; QoL was equivalent for both treatment modalities. These results were independent of prostate size, risk category, and prior indwelling catheter. No statistically significant differences were detected between arms in terms of complication rates, but in-hospital stay and time to catheter removal were significantly shorter with PVP. In the laser PVP group, three patients were readmitted to the hospital and two developed a urethral stricture. In the TURP group, two patients were readmitted, six developed a urethral stricture, and two developed bladder neck sclerosis. The study was published online on June 1, 2011, in European Urology.

"This is the second randomized clinical trial performed to date on the efficacy of the GreenLight HPS 120-W laser compared with transurethral resection of the prostate," concluded lead author Carlos Capitan, MD, and colleagues of the department of urology. "Results show the same efficacy for International Prostate Symptom Score reduction and maximum flow rate increase with shorter length of stay for laser photoselective vaporization of the prostate."

The GreenLight HPS Laser System, a product of American Medical Systems (Minnetonka, MN, USA), combines a 532-nm wavelength with advanced laser technology, allowing highly selective absorption in tissue hemoglobin, unimpeded by the procedural irrigant. Depth of tissue coagulation, irrespective of the power level utilized, does not exceed 1 mm - 2 mm, since most of the thermal energy is both consumed and carried away by the highly efficient vaporization effect.

Related Links:
Hospital Universitario Fundacion Alcorcon
Universidad Rey Juan Carlos
American Medical Systems