Transurethral Vapor Resection of Prostate-An Alternative Treatment for Benign Prostatic Hyperplasia > 100 g

Purpose: To assess the safety and effectiveness of transurethral vapor resection of prostate (TUVRP) for the management of prostate glands with a volume of > 100 g. Patients and Methods: Thirty-nine patients who were found to have benign prostatic hyperplasia and prostate volume of > 100 g, as determined by abdominal ultrasonography, were offered TUVRP between July 2002 and August 2008. International prostate symptom score (IPSS), prostate volume, postvoid residue (PVR), and maximum flow rate (Qmax) formed part of preoperative evaluation. We also assessed intraoperative and postoperative parameters, including operative time, irrigant fluid requirement, blood loss, duration of postoperative catheterization, hospital stay, and postoperative complications. Results: The mean prostate volume was 121.39 g (range 101-232 g). The mean age was 65.70 years (range 54-94 years). About 12 patients had a catheter preoperatively. Mean IPSS was 24.87 (21-28). Mean Qmax and PVR were 7mL/seconds (4-12) and 133mL (77-160), respectively. Mean operative time was 77 minutes (50-115), and mean irrigant fluid used was 26.48 L (18-36). Mean resected weight of prostate was 49.4 g (43-54). Average postoperative catheter duration was 2.38 days (2-2.5) with average postoperative hospital stay being 3.75 days (2-5). Effectiveness assessed at 6 months was IPSS 5.7, Qmax 20.5mL/seconds, and insignificant PVR. Conclusions: TUVRP is an alternative treatment modality for prostates > 100 g owing to its excellent intraoperative vision, shorter operative time, and reduced hospital stay.