| Traditional Monopolar TURP |
PK TURP provides the same Gold Standard outcomes in terms of AUA / IPSS, Qmax, PVR and QoL that has long been established with the traditional Monopolar TURP. However the hemostatic resection and use of low voltages provides a significant reduction in complication rate from 18.3% to 11.0% (p<0.001). TUR syndrome and dispersive pad burns are eliminated with PK TURP, minimizing potential medico-legal issues. Read more
Only 2 Randomized Controlled Trials (RCTs) have been published on Greenlight Photoselective Vaporization of the Prostate PVP Laser, both comparing with Monopolar TURP. In terms of efficacy, improvement in Qmax has been shown to be lower for PVP at 4 compared to 11 for PK TURP (Figure 1). 1,2
Figure 1 Comparison of BPH treatments for efficacy in terms of change in Qmax.
The overall complication rate for Greenlight PVP appears high at 31.8%, compared with only 11.0% complications for PK TURP(Figure 2).1,2
Figure 2 Comparison of BPH treatments for Overall Complication Rate
Issues continue to be reported with laser ablation of the prostate including:
- Long procedure times
- Inability to ablate sufficient tissue to achieve Gold Standard outcomes
- Effect of 5-alpha reductase treatments causing angiogenesis that limits available hemoglobin for PVP to vaporize tissue effectively
- Regrowth of tissue within 5 years
- Transient dysuria
- High overall complication rate
| Minimally Invasive Treatments (MIT) |
The low efficacy of MIT has been expressed by AUA 3 and remains as either initial
treatments or for high risk patients. PK TURP has the ability to provide full resolution of patient symptoms but with few complications, including similar erectile dysfunction to TUMT at <5% 4
1. Bouchier-Hayes DM, et al. KTP Laser vs. TURP: Early Results of a Randomized Trial; J Endourol 2006; 20: 580–585.
2. Shingleton WB, et al. Three-year follow-up of laser prostatectomy versus transurethral resection of the prostate in men with benign prostatic hyperplasia. ; Urology 2002; 60: 305–308.
3. AUA Practice Guidelines Committee: AUA Guideline on Management of Benign Prostatic Hyperplasia (2003). Chapter 1: Diagnosis and Treatment Recommendation. J Urol 170: 530-547, 2003.
4. Pu X, Wang X, Wang H, Hu L. Erectile dysfunction after plasmakinetic vaporization of the prostate: Incidence and Risk Factors. J Endourol 2006; 20: 693-697. |
