Prostate surgery in patients with benign prostate obstruction: A comparison between two methods

This study compared the effectiveness of transurethral prostate resection (TURP) and thulium laser vaporesection (TLV) in patients with benign prostate obstruction (BPO). Researchers suggested that both methods have similar effectiveness in these patients.

Benign prostate obstruction (BPO) is caused by prostate enlargement. The enlarged prostate might compress the urethra (urinary tube), stopping the urine flow. It affects around 3% of men aged 45 to 49 years in the UK, increasing to more than 30% of men aged 85 years or older.

The standard treatment for this condition is surgery, after failed treatment with medication. Conventional prostate surgery (TURP) is associated with a 0.3% death rate within 30 days and other complications. These complications can go from bleeding during surgery to urinary infection after surgery. Therefore, other surgery options, such as laser procedures have been developed over the past 20 years.

TLV is a type of laser surgery that uses laser-heat to remove prostate tissue and reduce its size. It has been suggested that this method is associated with a low rate of complications. However, the safety and effectiveness of TLV in the treatment of BPO compared to TURP are still not well known.

This study included 410 men with BPO and urinary symptoms. These patients were assigned to receive TURP (205) or TLV (205).

The maximum urinary flow rate was better for the TURP group (23.3mL) when compared to TLV (20.2mL). Both methods resulted in similar improvements in urinary symptoms at 12-months after surgery. The average hospital stay was 48h in both groups.

91 (45%) patients in the TURP group and 96 (47%) in the TLV group had at least one complication. The occurrence of sexual problems was also similar 12 months after both procedures.

This study concluded that TURP and TLV had similar effectiveness and side effects in patients with BPO and urinary symptoms.

This study included a small number of men of the non-white races. Also, the study does not account for the patients who needed conventional surgery after TLV. These patients were still assigned to the TLV group which might have affected the results.