OBJECTIVES: To evaluate in a prospective, randomised trial the surgical efficiency and safety of a new energy source enabling a continuous bipolar plasma vaporisation of the prostate (C-BPVP) by comparing with standard vaporisation (S-BPVP) and monopolar transurethral resection of the prostate (TURP) in men with benign prostatic hyperplasia (BPH). To comparatively assess the short-term functional outcome of the three methods. PATIENTS AND METHODS: In all, 180 men with BPH with prostate volumes of 30-80 mL, maximum urinary flow rates (Q(max)) of <10 mL/s and International Prostate Symptom Score (IPSS) of >19 were equally randomised for C-BPVP, S-BPVP and monopolarTURP. All men were evaluated preoperatively and at 1, 3 and 6 months after surgery by IPSS, Q(max), health-related quality of life (HRQL) score and post-void residual urine volume (PVR). The prostate volume and PSA level were postoperatively assessed at 6 months. RESULTS: The mean operation time was significantly reduced in C-BPVP vs S-BPVP and TURP, with a substantial 22.4% and 39.1% decrease in duration for C-BPVP when compared with S-BPVP and TURP, respectively. The mean haemoglobin level decrease (0.4 and 0.6 vs 1.4 g/dL), capsular perforation rate (1.7% and 3.3% vs 10%), postoperative haematuria rate (1.7% and 1.7% vs 13.3%), catheterisation period (24.1 and 23.9 vs 73.6 h) and hospital stay (2.1 and 2.2 vs 4.5 days) were significantly lower for C-BPVP and S-BPVP vs TURP. At 1, 3 and 6 months follow-up, there were statistically ameliorated IPSS and Q(max) measurements in the C-BPVP and S-BPVP series, while similar HRQL scores, PVRs, PSA levels and postoperative prostate volumes were found in all three study arms. CONCLUSIONS: The operation time for C-BPVP was on average 20% and 40% quicker than S-BPVP and TURP, respectively. Both C-BPVP and S-BPVP had better perioperative safety and improved follow-up voiding and symptom scores than TURP.
RCT Entities:
OBJECTIVES: To evaluate in a prospective, randomised trial the surgical efficiency and safety of a new energy source enabling a continuous bipolar plasma vaporisation of the prostate (C-BPVP) by comparing with standard vaporisation (S-BPVP) and monopolar transurethral resection of the prostate (TURP) in men with benign prostatic hyperplasia (BPH). To comparatively assess the short-term functional outcome of the three methods. PATIENTS AND METHODS: In all, 180 men with BPH with prostate volumes of 30-80 mL, maximum urinary flow rates (Q(max)) of <10 mL/s and International Prostate Symptom Score (IPSS) of >19 were equally randomised for C-BPVP, S-BPVP and monopolar TURP. All men were evaluated preoperatively and at 1, 3 and 6 months after surgery by IPSS, Q(max), health-related quality of life (HRQL) score and post-void residual urine volume (PVR). The prostate volume and PSA level were postoperatively assessed at 6 months. RESULTS: The mean operation time was significantly reduced in C-BPVP vs S-BPVP and TURP, with a substantial 22.4% and 39.1% decrease in duration for C-BPVP when compared with S-BPVP and TURP, respectively. The mean haemoglobin level decrease (0.4 and 0.6 vs 1.4 g/dL), capsular perforation rate (1.7% and 3.3% vs 10%), postoperative haematuria rate (1.7% and 1.7% vs 13.3%), catheterisation period (24.1 and 23.9 vs 73.6 h) and hospital stay (2.1 and 2.2 vs 4.5 days) were significantly lower for C-BPVP and S-BPVP vs TURP. At 1, 3 and 6 months follow-up, there were statistically ameliorated IPSS and Q(max) measurements in the C-BPVP and S-BPVP series, while similar HRQL scores, PVRs, PSA levels and postoperative prostate volumes were found in all three study arms. CONCLUSIONS: The operation time for C-BPVP was on average 20% and 40% quicker than S-BPVP and TURP, respectively. Both C-BPVP and S-BPVP had better perioperative safety and improved follow-up voiding and symptom scores than TURP.
Authors: Russell N Schwartz; Felix Couture; Iman Sadri; Adel Arezki; David-Dan Nguyen; Ahmed S Zakaria; Kyle Law; Dean Elterman; Malte Rieken; Hannes Cash; Kevin C Zorn Journal: World J Urol Date: 2020-09-15 Impact factor: 4.226
Authors: Benedikt Kranzbühler; Oliver Gross; Christian D Fankhauser; Marian S Wettstein; Nico C Grossmann; Lukas J Hefermehl; Matthias Zimmermann; Alexander Müller; Daniel Eberli; Tullio Sulser; Cédric Poyet; Thomas Hermanns Journal: World J Urol Date: 2016-06-23 Impact factor: 4.226