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Pure bipolar plasma vaporization of the prostate: Results from a prospective 3D ultrasound volumetry study with clinical outcome after 3 years


Hermanns, Thomas; Gross, Oliver; Fankhauser, Christian Daniel; Wettstein, Marian Severin; Grossmann, Nico Christian; Keller, Etienne Xavier; Eberli, Daniel; Kozomara, Marko; Sulser, Tullio; Poyet, Cédric; Kranzbühler, Benedikt (2019). Pure bipolar plasma vaporization of the prostate: Results from a prospective 3D ultrasound volumetry study with clinical outcome after 3 years. Journal of Endourology, 33(2):107-112.

Abstract

INTRODUCTION AND OBJECTIVES Bipolar plasma vaporization (BPV) has been shown to be a low-morbidity alternative to conventional transurethral resection of the prostate (TURP). Improved functional short-term outcome and postoperative prostate volume reduction comparable to TURP have been reported. However, comprehensive mid- or long-term results following BPV are still lacking.
METHODS A consecutive series of men who underwent pure BPV in a tertiary care academic center was prospectively investigated. Clinical parameters [International Prostate Symptom Score (IPSS) with Quality of Life (QoL) domain, peak urinary flow rate (Qmax), post-void residual volume (RV) and prostate specific antigen (PSA)] as well as prostate volume (assessed by planimetric volumetry following transrectal 3D-ultrasound) were recorded preoperatively and regularly after BPV (after catheter removal, 6 weeks, 6 months, 1 and 3 years). Statistical analysis was performed using the Wilcoxon signed-rank test. All p-values ≤ 0.05 were considered significant.
RESULTS Seventy-five men were included in this prospective investigation. Their median (interquartile range) prostate volume was 41.0 ml (30.6-57.4 ml). In the first year after BPV, the prostate volume continuously decreased over time and the relative volume reduction was 52.2 % after 12 months. Subsequently the volume reduction remained stable with 50.7 % after 3 years. All investigated outcome parameters improved significantly after the procedure and remained so after 3 years. Re-operations due to persistent or re-grown adenoma were not necessary. Six (8.0 %) and five patients (6.6 %) developed a de-novo urethral stricture or bladder neck contracture, respectively.
CONCLUSIONS Three years after pure BPV of the prostate a durable prostate volume reduction in combination with a stable improvement of functional outcome parameters was detectable in our prospective study. The low morbidity of the procedure and the possibility to perform BPV under ongoing platelet aggregation inhibition confirms its role as minimally invasive alternative to conventional TURP.

Abstract

INTRODUCTION AND OBJECTIVES Bipolar plasma vaporization (BPV) has been shown to be a low-morbidity alternative to conventional transurethral resection of the prostate (TURP). Improved functional short-term outcome and postoperative prostate volume reduction comparable to TURP have been reported. However, comprehensive mid- or long-term results following BPV are still lacking.
METHODS A consecutive series of men who underwent pure BPV in a tertiary care academic center was prospectively investigated. Clinical parameters [International Prostate Symptom Score (IPSS) with Quality of Life (QoL) domain, peak urinary flow rate (Qmax), post-void residual volume (RV) and prostate specific antigen (PSA)] as well as prostate volume (assessed by planimetric volumetry following transrectal 3D-ultrasound) were recorded preoperatively and regularly after BPV (after catheter removal, 6 weeks, 6 months, 1 and 3 years). Statistical analysis was performed using the Wilcoxon signed-rank test. All p-values ≤ 0.05 were considered significant.
RESULTS Seventy-five men were included in this prospective investigation. Their median (interquartile range) prostate volume was 41.0 ml (30.6-57.4 ml). In the first year after BPV, the prostate volume continuously decreased over time and the relative volume reduction was 52.2 % after 12 months. Subsequently the volume reduction remained stable with 50.7 % after 3 years. All investigated outcome parameters improved significantly after the procedure and remained so after 3 years. Re-operations due to persistent or re-grown adenoma were not necessary. Six (8.0 %) and five patients (6.6 %) developed a de-novo urethral stricture or bladder neck contracture, respectively.
CONCLUSIONS Three years after pure BPV of the prostate a durable prostate volume reduction in combination with a stable improvement of functional outcome parameters was detectable in our prospective study. The low morbidity of the procedure and the possibility to perform BPV under ongoing platelet aggregation inhibition confirms its role as minimally invasive alternative to conventional TURP.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Urological Clinic
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:1 February 2019
Deposited On:13 Feb 2019 13:56
Last Modified:25 Sep 2019 00:07
Publisher:Mary Ann Liebert
ISSN:0892-7790
OA Status:Closed
Publisher DOI:https://doi.org/10.1089/end.2018.0700
PubMed ID:30612441

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