Comparing reduction in prostate size between two minimally invasive procedures for BPH

This study compared outcomes of two minimally invasive surgical procedures used to treat benign prostatic hyperplasia (BPH). Researchers concluded that the recently developed transurethral bipolar plasma vaporization of the prostate (BPV) showed comparable treatment outcomes to the current standard-of-care.

BPH can lead to bothersome urinary symptoms and surgery is often required to remove the enlarged prostate tissue. A minimally invasive procedure called transurethral resection of the prostate (TURP) is the current standard-of-care. TURP allows for the destruction of prostate tissue through a wire loop inserted into the urethra (the penile opening).

A more recently developed alternative surgical procedure is transurethral bipolar plasma vaporization of the prostate (BPV). It has been associated with fewer complications and faster recovery time compared to TURP. However, whether BPV can achieve similar results to TURP in terms of amount of prostate tissue removed still being investigated.

The aim of this study was to compare the change in prostate size following BPV and TURP.

157 men with BPH were included in this study. 68 men underwent BPV and 89 men were treated with TURP. A three-dimensional ultrasound measured prostate size before surgery and 6 weeks, 6 months, and 12 months after surgery.

Before surgery, men in the BPV group had an average prostate size of 43.1 ml. Men in the TURP group had an average prostate size of 45.9 ml before treatment.

Prostate size was significantly reduced following both procedures. The average duration of catheterization (flexible tube inserted into the bladder to drain urine) was 3 days in both groups. The average hospital stay was 4 days for both procedures.

After catheter removal, prostate size was significantly higher in the BPV group (average 66.6% of initial size) compared to TURP (60.8%). However, at 12 months prostate size reduction was similar between BPV (46.6%) and TURP (47.1%). Further analysis revealed that BPV removed more tissue for men with initial prostate size of 45 ml or less, while TURP was more effective for larger prostates (45 ml or more).

17.6% of men in the BPV group and 2.2% of men in the TURP group developed a urinary tract infection at 6 weeks. Painful urination was reported in 38.2% (BPV) and 31.5% (TURP) of men at 6 weeks. However, this quickly subsided in most patients. 3 men in each group showed with a narrowed urethra. No patients required a repeat surgery.

Researchers concluded that prostate size reduction were comparable between BPV and TURP. Initial prostate size should be taken into account for men considering BPV or TURP.