TRANSURETHRAL ELECTROVAPORIZATION OF THE PROSTATE - A NOVEL METHOD FOR TREATING MEN WITH BENIGN PROSTATIC HYPERPLASIA

Objectives. To determine the preliminary safety and efficacy of trans-urethral vaporization of the prostate (TVP) using the VaporTrode as a therapeutic alternative in the management of men with bladder outlet obstruction. Methods. Twenty-five men (mean age, 63.5 +/- 3.1 years) with mild to moderate symptoms of prostatism underwent TVP since August 1994. Patients were assessed at baseline for both safety and efficacy and in follow-up at 1 week and 1 and 3 months. Efficacy parameters evaluated included operative time (in minutes), change in hematocrit and serum sodium, postoperative catheterization time, American Urological Association symptom score, peak uroflow (Q(max)) and postvoid residual urine. Safety parameters evaluated included incidence of side effects, changes in serum sodium and hematocrit, and evaluation of sexual function. Results. Symptoms decreased from 17.8 to 5.9 and 4.2 at 1 and 3 months, respectively (P < 0.01). Q(max) increased from 7.4 to 15.5 and 17.3 mL/s at 1 and 3 months, respectively (P < 0.02). Mean operative time was 40.5 minutes; mean interval to catheter removal was 14.6 hours. Changes in serum parameters included a 0.9 mL/dL decrease in hematocrit and a 1.1 mEq/L change in sodium. Complications of the procedure included mild hematuria (n = 3) and distal bulbar urethral stricture (n = 1). There were no associated significant postprocedure irritative symptoms and no patient required recatheterization. Conclusions. TVP is a new and potentially useful modification of performing transurethral resection of the prostate. In this preliminary study, there has been significant clinical improvement maintained with minimal morbidity. This early clinical experience highlights several potential advantages of TVP, including significantly lower cost and minimal postoperative irritative symptom score. Currently, a multicenter clinical trial is under way to determine the long-term efficacy and safety of TVP.