The long‐term results of transurethral vaporization of the prostate using plasmakinetic energy

Abstract

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.

Bipolar transurethral vaporization: a superior procedure in benign prostatic hyperplasia: a prospective randomized comparison with bipolar TURP

“…The published studies have reported significant improvement in IPSS and Q max with different follow-up durations for vaporization and vaporization-resection (including bipolar technology) in the case series (12,20,44,45) or in comparison with monopolar or bipolar TURP (19,34,43,(46)(47)(48) and our results are similar to those. In the meta-analysis studies, the PVP and B-TURP had similar results with M-TURP regarding IPSS and Q max especially in the short-term follow-up (6,14,22,31) Otsuki and co--workers reported significant improvement in IPSS between three months and one month after B-TUVP (8.8 vs. 11.1), but this matter wasn't proved about Q max (15.2 vs. 15.1mL/s) (20).…”

“…In Kaya et al research, PKVP (12%) had significantly higher re-operation rate than standard TURP (6.7%). But urethral stricture, erectile dysfunction and retrograde ejaculation were similar in both groups and no urinary incontinence or bladder neck stricture occurred (43). In Hon et al (17) and Karaman et al (47) studies, transfusion occurred only in the TURP group compared with PKVP.…”

Pure Bipolar Plasma Vaporization of the Prostate: The Zürich Experience

“…[17][18][19][20] However, midterm results have been reported to be inferior compared to TURP. 7,21 In 2008, a novel bipolar device using an ergonomic, hemispherical electrode and a different energy setting was launched. 22 To date, only limited data are available for this contemporary BPV technique.…”

Plasmakinetic vaporization versus plasmakinetic resection to treat benign prostatic hyperplasia: A prospective randomized trial with 1 year follow-up

“…[1][2][3][4] However, in one study comparing long-term results of transurethral vaporization of the prostate using plasmakinetic energy with conventional TURP, the authors concluded that the outcomes, like the International Prostate Symptom Score (IPSS) and maximum flow rates (Qmax), of PKVP after 3 years was statistically worse than TURP (p < 0.05). 5 Most studies until now have compared the outcomes of PKR or PKVP in BPH with monopolar TURP. [1][2][3][5][6] In this study, we compared the efficacy and outcomes of PKVP with PKR in the treatment of BPH.…”

“…5 Most studies until now have compared the outcomes of PKR or PKVP in BPH with monopolar TURP. [1][2][3][5][6] In this study, we compared the efficacy and outcomes of PKVP with PKR in the treatment of BPH.…”