Photoselective vaporization combined with bipolar transurethral resection for the treatment of large prostate adenoma in high-risk patients

OBJECTIVE: To evaluate the safety and effectiveness of the combined photoselective vaporization of the prostate (PVP) and bipolar transurethral resection of the prostate (TURP) in high-risk symptomatic patients with large prostates.

METHODS: Between January 2007 and January 2010, a prospective study was performed in Shandong Provincial Hospital, Shandong University, Jinan, Shandong Province, China. One hundred and one patients presenting with various kinds of systematic diseases, and with an American Society of Anesthesiologists score of 3 or greater underwent PVP plus bipolar TURP for severe lower urinary tract symptoms due to benign prostatic hyperplasia with prostatic volume greater than 80 ml. The International Prostate Symptom Score (IPSS) and quality-of-life questionnaire (IPPS-QoL), maximum flow rates (Qmax), postvoid urine residues (PVR), and MRI prostatic volumes were recorded. Perioperative data, functional outcome, and complications were evaluated. Patients were reassessed at 3, 6, and 12 months.

RESULTS: The mean operation time was 68.5 ± 23.9 minutes. The mean pre- and post- operative prostate volumes were 102.2±33.1 ml and 40.4±15.6 ml. No severe complications were observed. Significant differences in IPSS, Qmax, and PVR values were recorded within the follow-up period.

CONCLUSION: The results of our study show that PVP plus bipolar TURP have an excellent efficiency and low morbidity in high-risk patients with large prostates.