Objective To compare the safety, ef®cacy 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¯ow rate (Q max ). Results Both groups had comparable mean IPSS, QoL, Q max and PVR at baseline. The mean (SD) values for TUVP and TURP, respectively, at 3 years showed a signi®cant 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 Q max , 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 reoperation rate in each group was 4% during the ®rst 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 con®rm 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.

Transurethral electrovaporization of the prostate (TUVP) is one of the alternative, minimally invasive procedures to treat BPH with promising initial results. We reviewed the available English literature to evaluate the long-term safety, efficacy and durability of TUVP using various vaporizing electrodes. We performed a MEDLINE keyword search and assessed all prospective randomized studies, which compared TUVP to standard transurethral resection of the prostate (TURP) that reached 1 y follow-up. Data were analysed for improvement of IPSS and Q max , operation time, hospital stay, perioperative bleeding, postoperative irritative symptoms, long-term side effects and reoperation rate. We reviewed a total of 244 TUVP compared to 259 TURP patients in six prospective randomized studies that reached 1 y follow-up. Less perioperative bleeding, shorter catheterization time (mean of TUVP: 30 h vs TURP: 61 h) and shorter hospital stay (mean of 1.4 days vs TURP: 3.4 days) were reported in the TUVP patients. The improvement in IPSS (71%) and mean Q max (20 ml/s) was similar in both groups. The reoperation rate was 2% per year in both vaporization and resection patients. In conclusion, analysis of the prospective randomized trials that reached 1 year follow-up revealed that TUVP is as effective as standard TURP in the treatment of BPH. Long-term side effects and reoperation rates are comparable and the initial improvement was maintained over 1 year for the majority of patients.

Robotic-assisted pediatric urological surgery has emerged as a valid and reliable surgical therapy, which maintains the advantages of the minimally invasive approach but avoids the restrictions of laparoscopic surgery. The ideal application of the robot in the Pediatric population is in procedures requiring delicate suturing such as pyeloplasty or partial nephrectomy although the use of robotic surgery has been reported in a wide range of other procedures, particularly the diverse reconstructive pediatric operations. In this article, we review the current indications and results of robotics in the management of pediatric pathology.

The use of lasers to carry out resection of the prostate gland is an ever-evolving field which has seen several different modalities of laser light used with varying success. This review looks at what makes the traditional transurethral resection of prostate the gold standard and provides the evidence on the evolution of the laser prostatectomy in trying to usurp it as the favored procedure for symptomatic benign prostatic hyperplasia. In particular, we show how the latest laser technology in the form of the Greenlight laser is challenging not only other lasers such as the holmium laser, but may form a strong contender to replace the transurethral resection of prostate.