Outcome analysis of transurethral resection versus potassium titanyl phosphate-photo selective vaporization of the prostate for the treatment of benign prostatic hyperplasia; a randomized controlled trial with 4 years follow up

Objective: Photovaporization of prostate (PVP) is a newer surgical modality of benign prostatic hyperplasia (BPH) which is gaining importance recently. There are a few randomized controlled trials that showed safety and efficacy of PVP in comparison with transurethral resection of prostate (TURP) with limited follow- up period (<2 years). Here, we are presenting a comparative study performed on potassium titanyl phosphate (KTP) PVP laser versus TURP for the treatment of BPH with long- term follow-up period.

Material and methods: After institutional ethical clearance, 150 patients were prospectively included in the study from January 2010 to March, 2012. Improvement of International prostate symptoms score (IPSS), Qmax, post- void residual (PVR) urine, International index of erectile function (IIEF)-5 score and complications were assessed at 12, 24, 36 and 48 months.

Results: Mean age of the study group was 65.3±7.86 years in the TURP and 63.6±8.12 years in the PVP groups (p=0.45). IPSS symptom score improved significantly in both TURP and KTP groups (p<0.003). There was improvement in Q max during follow- up in both groups (p<0.001) which was maintained at 48 months. Most of the patients in both groups were satisfied with symptoms and bothersome at 48 months. All the sexual parameters are similar to both groups except retrograde ejaculation. Overall complication noted in 23 patients (15.33%).

Conclusion: Both KTP Laser PVP and TURP afford durable relief from symptoms of BPH at 48 months follow- up. Both procedures are safe and associated with minimal complications. Both procedures do not have any detrimental effect on sexual function on long- term follow- up. Quality of life remains high even at 4 years in both groups.