Prospective Randomized Comparison of Monopolar TURP, Bipolar TURP and Photoselective Vaporization of the Prostate in Patients with Benign Prostatic Obstruction: 36 Months Outcome

Abstract

Objectives: To assess durability of efficacy of monopolar transurethral resection of the prostate (TURP), bipolar TURP, and photoselective vaporization of the prostate (PVP) using 120W Green light laser at 36 months follow up.

Method: The 186 patients who presented with benign prostatic obstruction and planned for surgery were randomized into three groups: Group A - monopolar TURP; group B - bipolar TURP; and group C - PVP. International Prostate Symptom Score (IPSS), International Index of Erectile Function-5 (IIEF-5) score, quality of life (QoL) score, maximum flow rate (Qmax), prostate volume and postvoid residual urine (PVRU) were analyzed up to 36 months follow up.

Results: The improvement observed in the mean IPSS, QoL score, Qmax, prostate volume and PVRU at 12-month was sustained till 36 months follow up. However, the mean IIEF-5 score did not show improvement in any group. Few complications noted in second and third year of follow up compared to first year follow up. The results of subgroups analysis did not reveal any significant finding, different from group analysis, for efficacy parameters.

Conclusion: Monopolar TURP, Bipolar TURP and PVP provides durable and comparable efficacy at 36 months follow up in patients with prostate size <80 mL.

Keywords: benign prostatic obstruction; bipolar transurethral resection of prostate; monopolar transurethral resection of prostate; photoselective vaporization of the prostate.