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Transurethral electrovaporization of the prostate: one-year experience
S A Kaplan1, R P Santarosa, A E Te
1Department of Urology, College of Physicians and Surgeons, Columbia University, New York, New York 10032, USA.
Objectives:
To determine the safety and efficacy of transurethral electrovaporization of the prostate (TVP) in men with lower urinary tract symptoms.
Methods:
A prospective trial of 114 consecutive patients who underwent TVP since August 1994 was conducted. The mean follow-up period was 12.3 months. Parameters evaluated included American Urological Association symptom score (Sx), peak urinary flow rate (Qmax), operative time, postoperative catheterization time, length of hospital stay, and loss of days from work.
Results:
Of the 109 men available for follow-up, Sx decreased from 16.7 to 7.3, 6.5, 6.3, and 5.4 at 3, 6, 12, and 18 months, respectively (P < 0.001), whereas Qmax increased from 7.9 to 14.8, 15.6, 16.7, and 16.5 mL/s at 3, 6, 12, and 18 months, respectively (P < 0.001). Mean catheterization time was 10.4 hours; mean hospital period was 0.9 days, and average loss of days from work was 5.6. Complications included intermittent postoperative hematuria in 65 patients (57%). Clot retention in 6 (5%), and bulbar urethral stricture in 2 (2%). Of 74 men who were potent preoperatively, none had postoperative erectile dysfunction; retrograde ejaculation was noted in 62 (84%). Significant postoperative irritative symptoms were reported in 10 men (9%).
Conclusions:
On the basis of 1-year follow-up data, this study demonstrates that TVP is a safe and effective modality for treating lower urinary tract symptoms. However, longer, prospective, blinded studies are needed to determine efficacy relative to transurethral resection of the prostate.