OBJECTIVE To assess the long‐term efficacy and the safety of plasmakinetic vaporization of prostate (PKVP, Gyrus Medical Ltd., Bucks, UK) against standard transurethral resection of the prostate (TURP) for symptomatic prostatic obstruction. PATIENTS AND METHODS Of 75 patients admitted to our clinic with symptomatic prostatic obstruction between 2001 and 2003, 40 who were randomized to undergo either TURP or PKVP, and who had returned for the follow‐up, were included in this study. All treated patients completed the 36‐months of follow‐up; 25 had had PKVP and 15 a standard TURP. After surgery the treatment outcome was evaluated using the International Prostate Symptom Score (IPSS), maximum urinary flow rate (Qmax) and long‐term complications of surgery. RESULTS The two groups had similar baseline characteristics. The improvement in both groups was statistically significant for the IPSS and Qmax at 24 and 36 months vs the baseline values (P < 0.05). The mean (sd) IPSS decreased from 21 (3.4) to 7.1 (1.5) and 7.6 (1.4) after PKVP and from 22 (3.8) to 5.2 (1.1) and 5.7 (1.2) after TURP, at 24 and 36 months, respectively. The mean Qmax for the both groups increased significantly from baseline values at 2 and 3 years, respectively, at 20.8 (2.4) and 21.8 (3.1) mL/s after TURP, which was statistically significantly better than after PKVP, at 12.5 (2.1) and 14.4 (2.6) mL/s, respectively (P < 0.05). Although three patients (12%) in the PKVP group had TURP at 14, 20 and 36 months, respectively, for residual adenoma tissue, one patient had an additional operation after TURP. Bulbar urethral strictures occurred in one patient in each group, requiring internal optical urethrotomy. Erectile dysfunction was reported by three patients after PKVP (12%) and by two of 15 after TURP who were potent before surgery (P > 0.05). The retrograde ejaculation rates in patients with erectile function were similar in both groups (56% and nine of 15, respectively; P > 0.05). In the PKVP and TURP groups, 12 (48%) and nine of 15 patients were satisfied overall. CONCLUSIONS Although early results showed that PKVP was a good alternative technique among the minimally invasive methods for surgically managing prostatic obstruction, the clinical outcome of PKVP in the long term was not comparable to the results after TURP.

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Objective: The aim of this study was to investigate the relationship between obstructive sleep apnea syndrome (OSAS) and lower urinary tract symptoms (LUTS) in patients with benign prostatic hyperplasia (BPH).Methods: This multicenter study was performed on 122 male patients with dyspnea and/or sleep disorder. Patient characteristics were recorded. All patients underwent full-night polysomnography, and the apnea-hypopnea index (AHI) was calculated. LUTS were evaluated using the International Prostate Symptom Score (IPSS) and prostate volume was calculated by transabdominal ultrasonography. Based on the AHI, patients were classified as normal or as having mild, moderate, or severe OSAS. Regression analyses were performed to identify independent predictive factors associated with nocturia.Results: Severe, moderate, and mild OSAS was present in 53, nine, and 46 patients, respectively, where 14 patients with dyspnea and sleep disorder were classified as normal. There were no significant differences between the severe and mild OSAS groups with regard to age, body mass index, systolic and diastolic blood pressure, smoking history, fluid intake, and serum creatinine and glucose concentrations. However, there was a significant difference between two groups in AHI (P < 0.001), nocturia (P < 0.001), and nocturnal voided volume (P = 0.011). Univariate and multivariate analyses revealed that age, smoking history, and an AHI >15 were independent predictors of nocturia.Conclusions: Sleep disorders are thought to be one reason for nocturia and nocturnal polyuria.Thus, OSAS must be considered in BPH patients who predominantly have storage symptoms. K E Y W O R D Sbenign prostatic hyperplasia, nocturia, nocturnal polyuria, obstructive sleep apnea

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