Benedikt Kranzbühler, Oliver Gross, Christian Fankhauser, Lukas Hefermehl, Cédric Poyet, Remo Largo, Michael Müntener, Hans-Helge Seifert, Matthias Zimmermann, Tullio Sulser, Alexander Müller, Thomas Hermanns
Introduction and objectives: Greenlight laser vaporization (LV) of the prostate is characterized by simultaneous
vaporization and coagulation of prostatic tissue resulting in tissue ablation together with excellent hemostasis during the
procedure. It has been reported that bipolar plasma vaporization (BPV) of the prostate might be an alternative for LV. So
far, it has not been shown that BPV is as effective as LV in terms of tissue ablation or hemostasis. We performed
transrectal three-dimensional ultrasound investigations to compare the efficiency of tissue ablation between LV and
BPV.
Methods: Between 11.2009 and 5.2011, 50 patients underwent pure BPV in our institution. These patients were matched
with regard to the pre-operative prostate volume to 50 LV patients from our existing 3D-volumetry-database. Transrectal
3D ultrasound and planimetric volumetry of the prostate were performed pre-operatively, after catheter removal, 6 weeks
and 6 months.
Results: Median pre-operative prostate volume was not significantly different between the two groups (45.3ml vs.
45.4ml; p=1.0). After catheter removal, median absolute volume reduction (BPV 12.4ml, LV 6.55ml) as well as relative
volume reduction (27.8% vs. 16.4%) were significantly higher in the BPV group (p<0.001). After six weeks (42.9% vs.
33.3%) and six months (47.2% vs. 39.7%), relative volume reduction remained significantly higher in the BPV group
(p<0.001). Absolute volume reduction was non-significantly higher in the BPV group after six weeks (18.4ml, 13.8ml;
p=0.051) and six months (20.8ml, 18ml; p=0.3). Clinical outcome parameters improved significantly in both groups
without relevant differences between the groups.
Conclusions: Both vaporization techniques result in efficient tissue ablation with initial prostatic swelling. BPV seems
to be superior due to a higher relative volume reduction. This difference had no clinical impact after a follow-up of 6M.
Oliver Gross, Tullio Sulser, Lukas J. Hefermehl, Daniel D. Strebel, Remo Largo, Ashkan Mortezavi, Cédric Poyet, Daniel Eberli, Matthias Zimmermann, Alexander Müller, Maurice S. Michel, Michael Müntener, Hans-Helge Seifert, Thomas Hermanns
Introduction and objectives: It is unknown if tissue ablation following 120W lithium triborate (LBO) laser
vaporization (LV) of the prostate is comparable to that following transurethral resection of the prostate (TURP).
Therefore, transrectal 3D-ultrasound volumetry of the prostate was performed to compare the efficiency of tissue
ablation between LBO-LV and TURP.
Methods: Between 03/2008 and 03/2010 110 patients underwent routine LBO-LV (n=61) or TURP (n=49). Transrectal
3D-ultrasound with planimetric volumetry of the prostate was performed pre-operatively, after catheter removal, 6 weeks
and 6 months.
Results: Median prostate volume was 52.5ml in the LV group and 46.9ml in the TURP group. After catheter removal,
median absolute volume reduction (LV: 7.05ml, TURP: 15.8ml) and relative volume reduction (15.9% vs. 34.2%) were
significantly lower in the LV group (p<0.001). After 6 weeks/ 6 months, the relative volume reduction but not the
absolute remained significantly lower in the LV group.
Conclusions: LBO-LV is an efficient procedure evidenced by an absolute tissue ablation not significantly different to
that after TURP. However, TURP seems to be superior due to a higher relative tissue ablation. The differences in tissue
ablation had no impact on the early clinical outcome. Delayed volume reduction indicates that prostatic swelling occurs
early after LV and then decreases subsequently.
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