Russell N Schwartz1, Felix Couture2, Iman Sadri3, Adel Arezki3, David-Dan Nguyen3, Ahmed S Zakaria4, Kyle Law3, Dean Elterman5, Malte Rieken6,7, Hannes Cash8, Kevin C Zorn9. 1. Université de Montréal, Faculté de Médecine, Montreal, Canada. 2. Département d'Urologie, Centre Hospitalier de l'Université de Sherbrooke, Montreal, Canada. 3. McGill University, Faculty of Medicine, Montreal, Canada. 4. Département d'Urologie, Centre Hospitalier de l'Université de Montréal, Montreal, Canada. 5. Division of Urology, University of Toronto, Toronto, Canada. 6. alta uro AG, Basel, Switzerland. 7. University of Basel, Basel, Switzerland. 8. Department of Urology, Charité Universitätsmedizin Berlin, Berlin, Germany. 9. Département d'Urologie, Centre Hospitalier de l'Université de Montréal, Montreal, Canada. zorn.chumurology@gmail.com.
Abstract
PURPOSE: In the current review, we will discuss the state of the literature of vaporization of the prostate for the treatment of benign prostatic enlargement (BPE). We discuss two methods of vaporization of the prostate: Transurethral Vaporization of the Prostate (TUVP) and Greenlight Photo-selective Vaporization of the Prostate (PVP). METHODS: A comprehensive review of the literature was performed on TUVP and PVP. The literature on transurethral resection of the prostate (TURP) was also extensively reviewed as a comparative surgical method. RESULTS: The evidence shows that TUVP appears to be the safer choice, as compared to TURP due to less intra- and peri-operative complications. PVP was associated with less bleeding complications than TURP with outpatient discharge. Importantly, PVP was not associated with serious bleeding events requiring blood transfusions or medical treatment in patients under anticoagulation or antiplatelet therapies. PVP was also shown to be a cost-effective option compared to TURP. CONCLUSION: Prostate vaporization for the treatment of BPE appears to be an efficient and safer alternative to TURP. Vaporization techniques, particularly Greenlight PVP, should be offered to most men, especially those under anticoagulation therapy, as well as patients at risk of bleeding complications.
PURPOSE: In the current review, we will discuss the state of the literature of vaporization of the prostate for the treatment of benign prostatic enlargement (BPE). We discuss two methods of vaporization of the prostate: Transurethral Vaporization of the Prostate (TUVP) and Greenlight Photo-selective Vaporization of the Prostate (PVP). METHODS: A comprehensive review of the literature was performed on TUVP and PVP. The literature on transurethral resection of the prostate (TURP) was also extensively reviewed as a comparative surgical method. RESULTS: The evidence shows that TUVP appears to be the safer choice, as compared to TURP due to less intra- and peri-operative complications. PVP was associated with less bleeding complications than TURP with outpatient discharge. Importantly, PVP was not associated with serious bleeding events requiring blood transfusions or medical treatment in patients under anticoagulation or antiplatelet therapies. PVP was also shown to be a cost-effective option compared to TURP. CONCLUSION: Prostate vaporization for the treatment of BPE appears to be an efficient and safer alternative to TURP. Vaporization techniques, particularly Greenlight PVP, should be offered to most men, especially those under anticoagulation therapy, as well as patients at risk of bleeding complications.